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 an intolerance to cow’s milk, and in our area, 60% of those babies will also develop an intolerance to soy proteins. Many families note a familial link, often having more than one child with this diagnosis. There may even be a history of a parent needing a “special diet” as an infant.
What are the symptoms of MSPI?
Children with MSPI may cry for 18 hours or more a day and develop weight loss, congestion, repeated vomiting, acid reflux, and certain types of skin rashes. They may also experience changes in appetite, including food refusal or overeating, irritability, fussiness, and blood or mucus in the stool.
What is the difference between colic and MSPI?
Many infants with MSPI will exhibit colicky behavior. Colic usually begins around 2 to 3 weeks of life when babies cry, often inconsolably, during the evening. The baby may be temporarily soothed by walking, rocking, or car rides. If your baby shows these symptoms, it’s essential to work with your health care provider to ensure the baby is not suffering from MSPI. Colic alone doesn’t lead to weight loss or health issues, but MSPI can.
What is the difference between MSPI and Lactose Intolerance?
MSPI differs from lactose intolerance. MSPI is intolerance to the milk protein, while lactose intolerance is due to a lack of the enzyme that breaks down lactose, the main sugar in cow and human milk. While the two conditions have similar symptoms, lactose intolerance is rare in infants. Older children and adults may develop it later in life. Lactose-free formula won’t help with MSPI, as it still contains cow’s milk protein, which causes symptoms in babies with MSPI.
How is MSPI diagnosed?
Diagnosing MSPI can be challenging as there is no specific test. Your doctor may test for blood in the stool, which can be caused by MSPI or other health issues. The best way to confirm MSPI is through an elimination diet, where the baby stops consuming cow’s milk and/or soy. Your healthcare provider will guide you, as many foods contain milk and soy under different names. If the baby improves within two weeks, MSPI is likely the cause.
What is the treatment for MSPI?
There is no medication for MSPI. Treatment for breastfed babies involves the breastfeeding mother following a diet free of cow’s milk and soy. For formula-fed babies, hypoallergenic formulas such as Alimentum, Nutramigen, Elecare, or Neocate are recommended. Additionally, babies with MSPI should avoid solid foods until about six months of age. At that point, solid foods should be introduced in a slightly different order than for babies without MSPI, following advice from your healthcare provider.
Will my baby get better?
The long-term outlook for babies with MSPI is very positive. Most outgrow the condition by 12 months and can consume cow’s milk and soy products without issues. Your practitioner will help determine when to reintroduce these foods into your child’s diet.