What is MSPI?

Milk soy protein intolerance (MSPI) is a temporary inability to digest the proteins found in cow’s milk and soy products.  MSPI is different from a traditional food allergy.  You may also see it referred to as food protein-induced colitis or cow’s milk protein intolerance (CMPI).  It may be related to other diagnoses, including eosinophilic gastroenteritis/ esophagitis, or allergic colitis.

Who can develop MSPI?

Any baby can develop intolerance to cow’s milk and/or soy proteins. It does not matter if the baby is breastfed or formula-fed.  As many as 2-7% of babies under one year of age have intolerance to cow’s milk, and in our area, 60% of those babies will also develop intolerance to soy proteins.  Many families note a familial link, often having more then one child in the family with this diagnosis.  There may be a history of a parent needing a “special diet” as an infant.

What are the symptoms of MSPI?

Children with MSPI may cry 18 hours or more a day and may develop weight loss, congestion, repeated vomiting, reflux, and certain kinds of skin rashes.  They also may have changes in appetite, including refusing food or wanting to eat all the time, irritability/fussiness, and blood or mucous in their stools.

What is the difference between colic and MSPI?

Many infants with MSPI will display colicky behavior.  Colic is one of the mysteries of nature.  It tends to start at about 2 to 3 weeks after birth, when a baby will have crying spells, mainly in the evening.  The baby may be inconsolable.  Walking, rocking, or car rides may temporarily stop the crying.  If your baby is acting colicky, it is important that you work with your health care provider to make sure your child is not suffering from something more, such as MSPI.  Colic by itself does not cause weight loss or other health problems, but MSPI can.

What is the difference between MSPI and Lactose Intolerance?

MSPI is not the same as lactose intolerance. MSPI is intolerance to the actual milk protein.  Lactose intolerance is a deficiency in the enzyme that breaks down lactose, which is the major sugar found in both cow and human milk.  These two conditions are often confused, as their symptoms are similar.  It is very rare for lactose to cause a problem in infants, although older children (over the age of 5) and adults may develop this problem later in life.  Feeding lactose free formula does not help in infants with MSPI.  Lactose free formula will still contain the cow’s milk protein that causes the infant’s symptoms.

How is MSPI diagnosed?

Making the diagnosis of MSPI can be difficult.  There is no specific test for MSPI.  Your child’s doctor can test for blood in the stool, which can be caused by MSPI, but can also be caused by other health conditions.  The least invasive test is called an elimination diet.  This means that the baby is not fed anything with cow’s milk and/or soy.  Your healthcare provider can help you with this diet, as some foods contain cow’s milk or soy ingredients that are listed under different names.  If the baby’s symptoms are related to cow’s milk and/or soy intolerance, the baby should get much better on this diet.  It can take up to 2 weeks for the proteins to be entirely out of the baby’s system, but parents should see an improvement in symptoms over this time period if the baby has MSPI.

What is the treatment for MSPI?

There is no medication for MSPI. The only treatment for breast-fed babies is for the mother to eat a diet free of cow’s milk and soy.  For formula-fed infants, a hypoallergenic formula, such as Alimentum, Nutramigen, Elecare, or Neocate can be used.  Your practitioner will recommend one.  Babies with MSPI also do better if solid foods are not introduced until around 6 months of age.  At that time, solid foods can be introduced in a slightly different order than for babies without MSPI.  Your healthcare provider can review the solid food instructions with you as your baby nears 6 months of age.

Will my baby get better?

The long term outcome for babies with MSPI is very good.  Most babies outgrow this intolerance by 12 months of age, sometimes sooner, and are able to consume cow’s milk and soy products without concern.  Your practitioner will help you decide when to try adding cow’s milk and soy protein back into your child’s diet at the appropriate time.