Recognizing the Signs of a Milk Soy Protein Intolerance

Imagine that you’re sitting in the nursery rocking your sweet bundle of joy to sleep after one of those late night feedings trying to stay awake when you realize that something isn’t right. Within seconds, the screaming begins and no amount of shushing, pacing, or rocking is helping. 

Interestingly enough, you recognize that feeding your baby causes him to be even more unsettled. He’s got to be hungry, but his reflux is terrible; and to suggest that he has an upset stomach is the understatement of the year! And the diapers? WOW! Besides being runny, they make you want to dress up as if you were conducting some sort of chemistry experiment – goggles included! That gorgeous little face has a terrible rash and it seems that it’s just getting worse. You’ve been to the doctor countless times, but it’s always brushed off as baby eczema and they send you on your way.

But something isn’t right. There has to be more to it. What happened to your once happy baby who slept well and was growing at a rapid rate? That same baby is now crying non-stop (unless they are being held… all-night-long) and you’re losing your mind. While it’s certainly possible that your baby has a bad case of baby eczema or colic or something of the sort, we know that mommy’s intuition is something that can’t be ignored. Thus, today we discuss what is known as a Milk, Soy, Protein Intolerance (aka MSPI) diagnosis. 

What is MSPI?

Milk, Soy, Protein Intolerance (MSPI)
A temporary inability to digest the proteins found in cow’s milk and soy products. Often referred to as food protein-induced colitis or cow’s milk protein intolerance (CMPI). 

Who can develop MSPI?

While MSPI can affect any person who can’t tolerate eating anything that has a milk or soy protein-derived ingredient, it is most commonly discovered in infants or young children who can’t yet communicate what hurts.


Proteins are like lego’s.

Most kids can process a big lego, made up of lots of small pieces. Meanwhile, some kids have slightly under-developed intestines with little spaces between the cells. Those big pieces of protein get caught in those spaces and the body attacks those proteins, causing an irritation in the intestine, which causes blood in the stool. 


Although symptoms can vary from baby to baby, common symptoms include:

  • Reflux
  • Upset stomach
  • Gas
  • Runny and painful bowel movements
  • Blood or mucus in the stool (could be as minimal as little streaks like lint from a sweater)
  • Congestion
  • Rough rash on the face, head, and chest
  • Colicky behavior (crying 18 hours or more)
  • Abnormal sleep patterns
  • Refusal to eat
  • Constantly eating and purging
  • Weight loss

How is MSPI diagnosed? 

Unlike many food allergies, diagnosing MSPI is difficult because there are no specific MSPI tests. It’s mainly diagnosed through symptoms. However, your pediatrician can test for blood in your child’s stool. Therefore, if you see blood in your infant’s diaper, call the pediatrician immediately!

Collecting a Sample

  • Line your baby’s diaper with cellophane, so you can collect the next blow out and put it in a sterile container.
  • Keep it in the freezer (we suggest double bagging with a ziploc bag to keep everything contained and prevent leakage) until you can take it to the lab.
  • Let your pediatrician know you will collect the stool for them. They may give you a container or tell you to sterilize a baby food jar. Some pediatricians will even accept the diaper. Do whatever is asked of you and bring it in. 

Keep track of your child’s symptoms and talk to your pediatrician. Express your concerns and your research findings in a “no-nonsense” manner if you have to. If your child is an adorable chunky baby and is well within the weight range for their age, you may get the “oh it’s just a virus” diagnosis, so don’t be surprised if you have to go back to your pediatrician’s office multiple time before you get a diagnosis. 

Now What? 

There are two main courses of actions for a MSPI diagnosis. 

1. Elimination Diet

If baby is breast-fed, momma must remove all dairy and soy protein from her diet. But before you remove anything from your diet, read the labels! The words nondairy on a product label indicate it does not contain butter, cream, or milk. However, this does not necessarily indicate that the item does not have other milk-containing ingredients.

The Kosher food labeled pareve almost always indicates food is free of milk and milk products. A “D” on a product label next to the circled “K” or “U” indicates the presence of milk protein. 

What to Avoid:
  • Processed meats: hot dogs, sausages, lunch meats.
  • Meats, fish, poultry, & cheese: All cheese, breaded meat, meatloaf, croquettes, casseroles, hamburgers-unless made without milk.
  • Potatoes & Substitutes: Au gratin, buttered, creamed, scalloped potato or substitutes. Macaroni and cheese. Frozen french fries sprayed with lactose. Mashed potatoes containing milk or butter.
  • All milks: whole, low-fat, skim, buttermilk, evaporated, condensed, powdered hot cocoa
  • Breads: Wheat, white, or rye, biscuits, donuts, muffins, pancakes, waffles, crackers, saltines- most commercially prepared breads and rolls contain milk or milk products.
  • Cereal: High protein cereals. Prepared and precooked cereals with milk solids, casein, or other milk products added.
  • Desserts: Pastries brushed with milk, junket, popover. Cakes, cookies, custard, pudding, cream desserts, or sherbet containing milk products.
  • Sweets: Candy made with milk – chocolate, fudge, caramels, nougat.
  • Eggs
  • Fats: Butter, cream, margarine, salad dressing or mayonnaise containing milk, milk solids or milk products. Some butter substitutes and non dairy creamers.
  • Fruits: Any served with milk, butter or cream.
  • Soups: All soups made with milk or milk products. Bisques, chowders, creamed soups.
  • Vegetables: Au gratin, buttered, creamed or escalloped vegetables. Batter and dipped vegetables. Vegetable souffles.
  • Miscellaneous: All items containing milk, cheese, butter, whey casein, caseinates, hydrolysates, lactose, lactabumin, lactalbumin phosphate, lactoglobulin or milk solids, artificial butter flavor.

Other possible sources of milk or milk products:

  • Brown sugar flavoring
  • High Protein flour
  • Margarine
  • Natural flavoring
  • Simplesse

2. Hypoallergenic Formulas

The hypo-allergenic formulas break the proteins down into smaller pieces helping the food pass through.

There are different hypoallergenic formulas that can be used to ease the pain that your baby feels when eating; such as Neocate or EleCare which you can find online or through your local pharmacy. These formulas are even more specialized than the Nutramigen or Alimentum, thus more expensive. You can also try Enfamil Nutramigen or Similac Alimentum as these are easier to find in the store.

Although these formulas are pricey some insurances will cover the expense so contact your insurance company and see what they can do, it can be considered “failure to thrive” and then they will cover it!

There is currently no cure for MSPI, just time. Children will outgrow the intolerance, some as early as 1 year old or much later. A few unlucky ones may not ever outgrow it. The MSPI diet isn’t exactly fun, but there are good resources out there that will help you along the way. As long as baby is growing and gaining weight keep up the good work, it means they are thriving!

Milk allergies often exist into childhood. Luckily, cow’s milk isn’t our only option. For more information, check out Milk Options & Alternatives Beyond Babyhood.

Photo Credits: Morgan and Pixabay
Source: Complete Children’s Health and Stanford Children’s Health

This post is meant for educational purposes only. It is not intended to replace medical advice from your physician, doctor or health care professional. Please read our terms of use for more information.

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Annie Butler

Annie lives in North Carolina with her husband and 3 kids. Being a full-time student with a 7 year old Gracie, 2 year old Kate and a 6 month old Reid her life is hopping! On any given day you can find her dressing up for tea parties or being the victim of toddler makeovers in-between writing papers or chauffeuring her oldest from all the activities she is in! Her favorite pastimes are camping with the family, the beach, trying to hit the gym, and a great book!

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