MSPI or Milk Soy Protein Intolerance is a condition in which infants are temporarily unable to digest the proteins found in milk and soy. These issues with digestion can lead to frequent crying, weight loss, congestion, reflux, repeated vomiting and certain kinds of skin rashes. These infants may also exhibit colicky symptoms due to the pain from their poor digestion.
What can you do?
After working with many families caring for infants with acid reflux, I have seen a fair amount of those infants go on to be diagnosed with MSPI. This is especially true for infants who did not respond to the standard treatments for acid reflux. If you have a baby with acid reflux who is not responding to treatment, you may want to ask your pediatrician about the possibility of MSPI.
In infants with MSPI who are being breastfed the mother will have to alter her diet. The mom’s diet will have to be free of all sources of milk and soy. This may require a lot of label reading and it is usually best to stick with whole, unprocessed foods. Processed foods can often sneak in these triggers in the forms of fillers. Milk can be hidden on labels in various terms like cream, casein, lactulose or hydrolysates. Soy also can be a sneaky food to eliminate, as it can be hidden by names like textured vegetable protein, kinnoko flour or yuba. The Kids With Food Allergies website has a more exhaustive list for MILK and SOY terms you will want to know.
For formula-fed babies there are specialized formulas that do not contain soy or milk. These formulas are generally referred to as "hypoallergenic," or elemental. These include formulas like Pregestimil, Alimentum and Nutramigen. These formulas are called extensively hydrolysed formulas (EHF) because they have more broken down proteins that are easier to digest. These can be great in children who have reflux symptoms that are severe or are complicated by MSPI or food allergy.
If your child has even more serious issues with food allergies or absorption and has failed a trial run of one or more of the EHF’s it might be time to look into whether an amino acid-based formula can help. Three of the most well recognized are Elecare, Neocate and Nutramigen AA. These formulas have proteins that are broken down into the most basic of component, the amino acid. This prevents most reactions and is easier on the digestive tract because most of the "work" of breaking down the formula has already been done.
What to expect
It can take two full weeks in order to get all of the milk and soy proteins out of the infants system. This is especially true for breastfeeding because the proteins not only have to be removed from baby’s system but first they have to be removed from mom. So, be patient. You should see continued improvement each day. The best news? Most kids will outgrow MSPI by the time they are a year old.
Jennifer Rackley is a nutritionist and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and graduate work in public health nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.