Deborah Uranowitz

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?

New Delhi: The Biju Janata Dal (BJD) was formed at a time the BJP was seeking to find a foothold in the coastal state of Odisha which, as the latter realised, it could only do by forging an alliance with a regional partner. This regional partner was the BJD, formed out of a breakaway faction of Janata Dal, and led by Naveen Patnaik, the son of former Odisha CM Biju Patnaik.

It is ironic then that today, as the BJD under the leadership of Odisha CM Naveen Patnaik gears up to steer the party for a sixth straight term in office in 2024, the biggest challenge it faces is from the BJP.

From a small regional party, the BJD has come a long way in the last 25 years. It is probably the only regional party that has not lost a single  election it contested since it was formed in December 1997. While the party completed 25 years last week, Naveen Patnaik has had an uninterrupted twenty two-and-a-half year stint as CM.

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The BJD was formed in 1997 with leaders from the breakaway faction of Janata Dal, recalled former Union minister and prominent Odia politician Srikant Jena, who was with the Janata Dal back then.

According to Jena, the BJD actually emerged from the BJP’s manoeuvers in the state after the Janata Dal split.

Naveen Patnaik was already an MP, winning his debut by-election on a Janata Dal ticket from the Aska Lok Sabha seat after his father’s death in 1997. Soon after, the Inder Kumar Gujral government at the Centre collapsed when the Congress withdrew its support. There was a split in the Janata Dal and the BJP saw an opportunity there.

Jena said that Biju babu (Naveen Patnaik’s father) was against an alliance with the BJP. After his death and Janata Dal’s split, BJP leader Pramod Mahajan came to Jena, requesting for an alliance. “He said that the BJP just needs five Lok Sabha seats from Odisha to support Atal ji’s candidature for Prime Minister. I said I can’t have an alliance with the BJP at which Mahajan told me that the party is going to split,” Jena said.

“A major section from Odisha Janata Dal chose to go along with the BJP. The main opponent of Janata Dal in Odisha was the Congress. To defeat the Congress, it was a compulsion for them to join hands with the BJP. At that point of time, political convenience was more attractive for them than ideological compulsion. The Congress was in power in Odisha and they wanted to defeat it,” Jena, who later joined the Congress, said.

Soon after, Naveen Patnaik along with Dilip Ray, an old loyalist of Biju Patnaik, and other Janata Dal leaders, joined hands and formed the BJD.  “That is how they got together and the BJP and the BJD became successful and for 10 years, ran the government together. Pramod Mahajan was the key man on behalf of Atal Behari Vajpayee. They had a plan… They calculated they need at least five BJP MPs and others should support Vajpayee. It (planning) was done at the apex level,” Jena said.

When the BJD was formed, Naveen Patnaik was new to politics. Aided by former Janata Dal leaders such as Dilip Ray and Bijoy Mohapatra, who were close to his father, he steered the party forward and learnt how to manoeuvre situations to his advantage.

Speaking to ThePrint, Suresh Kumar Pujari, BJP’s Bargarh MP, talked about how Patnaik shrewdly started sidelining  the BJP after forming the government and eventually ended the alliance in 2009.

“It was the BJP which facilitated the split of Janata Dal, and the formation of BJD as a regional party so that we could forge an alliance and fight the parliamentary election. It was a healthy alliance. But the BJD deliberately tried to sideline us, taking advantage of the situation in those days. We needed their support to ensure that the Vajpayee government at the Centre runs. In 2004, NDA lost the election but we (the alliance) won the election In Odisha,” Pujari said.

From 2004 to 2009, the BJD started working towards terminating the alliance, he said. “We were caught off guard when the alliance was terminated by Naveen babu. Perhaps, they succeeded because of Naveen babu’s planning in advance,” the BJP MP said.

It was not just the alliance with the BJP that Patnaik ended. Along the way, he also sidelined senior leaders such as Dilip Ray, Bijoy Mohapatra, and Pyari Mohapatra who had stood by him from the initial days.

Ruben Banerjee, former editor of Outlook, who has followed Panaik since his early days and has chronicled his political journey in his book ‘Naveen Patnaik’ said that the BJD has transformed itself from the anti-establishment party of 1996-97 to the establishment party now.

“They came with the promise they will change the establishment. Now all the contractors, power brokers at the ground level or block level or panchayat level are supporters or members of the BJD. So now, they represent the establishment. Having come to power on the anti-establishment plank, now they represent the establishment’s interest. Nothing moves without the partymen,” Banerjee told ThePrint.

Political analysts say that Patnaik is not oblivious to the threat posed by the BJP and at 76 years, is raring to go. If anything, the defeat at the hands of the BJP in the Dhamnagar by-election recently has come as a warning bell for the party and forced it out of its complacency.

Patnaik is leading from the front. Belying rumours of his ill health, the Odisha CM has started touring the state, reaching out to the people directly, holding meetings with his party workers as he prepares the ground for 2024. He was in Balasore on 22 December launching projects worth crores, addressed party workers in Puri on 26 December as the party celebrated its foundation day, and visited Angul on 29 December.

Party leaders also question the narrative that Patnaik is in cahoots with the BJP because it has supported the party during passage of contentious bills in the Parliament.

According to Prasanna Acharya, BJD Rajya Sabha MP and one of the founder members of BJD, Patnaik is unlike a typical politician. “He never accuses others, he never retaliates with harsh words. He always tries to keep a good rapport with people. He does not believe in confrontation or compromise. But, where the interest of the state is concerned, he is the last man to compromise,” he said.

The BJD leader added that Patnaik has raised a strong voice every time the BJD has felt its interest getting compromised by certain actions of the central government.

Political observers said that it’s a mix of a careful narrative that has been built around Naveen Patnaik and the welfare politics that has made him click with the masses despite over 22 years at the helm. A disorganised Opposition has ensured that the BJD continues to be in the front seat.

According to former BJD MP Tathagata Satpathy, Patnaik has a mass connect. “And he is probably preserving that for his own interest,” Satpathy, who is the editor of Odia newspaper Dharitri, told ThePrint.

Political observers say that even after over  22 years in power, there is hardly any dent on Patnaik’s personal popularity. He is seen as a leader with a clean image and simple lifestyle. Coupled with the plethora of welfare schemes introduced by his government, especially targeting women, the rural poor, farmers, old and the youth, Patnaik has ensured that he continues to hold sway in the coastal state with  83% rural population and 48.4% women voters.

“There has been no change in this image of Patnaik since he first took over as CM. Besides the plethora of pro-poor schemes that he has introduced, it is his simplicity that continues to endear him to the common man even after all these years,”  Bhabani Shanker Tripathy, deputy general manager (news) of Odia daily Sambad, Odisha largest circulating newspaper, told ThePrint.

Tripathy said that Patnaik created a very careful narrative of himself as a simple man with bare needs after he entered politics. “Up to 55 years of age, the narrative was that he loved the good life, lived in foreign countries, socialised with the elite etc. But after coming to Odisha, he created a different narrative for himself,” he said.

For all the political accumen that Patnaik now displays, he started off as a reluctant politician. Acharya told ThePrint that Patnaik was not a politician. “He was an artist, he drew very good pictures. He had a different kind of personality. When he decided to come to Odisha and take on the leadership, many people said that he will not succeed, the party will disintegrate. But he has proven them wrong,” he said.

According to Banerjee, Patnaik has managed the public perception very well. “Though he has executed some very unclean political manoeuvres, he has ensured that no dirt has stuck to him. He has remained Mr Clean,” Banerjee said.

Party leaders said that it is Patnaik’s unparalleled support among the women that has majorly contributed to BJD’s success.

They said that it was during the time of Biju Patnaik that Odisha was among the first states in the country to bring  33% reservation for women in the panchayati raj. Patnaik increased it to 50%, Acharya said.

The emphasis on women empowerment was very clear from early on. “The Self Help Group (SHG)  that we have formed all over the state has ensured that women in the household do not depend on their husband or son. It is empowering women. Now when we hold meetings in the village, we find many more women than men. It’s a social revolution,” Acharya said.

Today, Odisha has six lakh women SHGs. “There are 70 lakh women spread across 30 districts, who are associated with SHGs  and the kind of socio economic transformation that we find is truly transformational,” BJD Rajya Sabha MP Sasmit Pal said.

According to political observers, Patnaik may be a ‘gentleman’ politician but he has a hawk’s eye on the administration and an iron grip over his party.

An instance of Patnaik’s hold over the party is reflected in the way party MPs wait to be told the line they have to take in the Parliament when it is in session. “On any important issue, the line that party MPs take on any every issue is decided by the CM. Even on questions related to the state, what answer has to be given is decided by the chief minister’s office in advance,” an Odisha cadre bureaucrat told ThePrint.

Party leaders said that Patnaik has proved his mettle as an able administrator.

Though he does not interfere in the day-to-day work of the administration, that does not mean that he is not clued in. “He keeps a hawk’s eye over governance. He has made it clear that he won’t tolerate corruption. He does not think twice before taking strict action against a bureaucrat or a minister accused of serious corruption charges,” Acharya said.

BJD leaders said that the reason the party has held sway in the coastal state is because from day one, Patnaik has served people from his heart.

“Built on that core value of service to the people of Odisha, he has driven, developed, engaged and built this leadership which is so transformational in nature,” said Patra.

Giving examples of transformation, Patra said that the state was almost drowning in poverty when Patnaik took over as CM. “He has pulled one crore people out of poverty, as per Niti Ayog estimates. Odisha has seen 25 % poverty reduction, which is the highest in any state. Besides, 80 % of the people are covered under food security schemes,” Patra said.

But not all agree.

Jena, who was expelled from the Congress in 2019, said that it is wrong to assume that Odisha has taken great strides under Patnaik’s leadership.

“Despite Naveen Patnaik being at the helm of affairs for over 22 years, Odisha continues to be a poor state.  Why is its per capita income the lowest? Why is the highest migration taking place from Odisha? You can organise World Cup hockey in Odisha, hold a very good conclave, but where are the jobs?” asked Jena.

Patnaik has been winning election after election because there is no challenger, added Jena. “Only one team is playing on the field, others are proxy, so the team that is playing will win.Who is the real challenger to Naveen Patnaik today? Everybody is a partner in the loot taking place in the state,” he said.

Jual Oram, BJP MP from tribal-dominated Sundargarh, said that the anti incumbency against the Patnaik government after all these years has started reflecting and manifesting.

“The resentment of people is growing. The BJD has been in power for over 22 years but where does Odisha stand at the national level? There are no jobs, the economic condition has worsened, corruption is rising. What is the government doing?” Oram said.

Political observers said that the BJD had a great ride so far but the future looks uncertain once Patnaik decides to hang his boots.

According to Banerjee, it is going to be “very choppy water.”

“He has not groomed anybody. So there will be a vacuum. The BJP will also be trying its luck, it has a lot of resources and they are the number two party in the state. If BJD does not find a leader of stature then, the party may split and BJP will swallow it up,” Banerjee said.

But Banerjee does not see a situation where the BJD is not present. “The BJP can’t wish away the BJD, it will still be there. It has its structure in place. It has lots and lots of resources. All that the party needs is a credible leader, credible face,” he said.

A former BJD leader who didn’t want to be named said, “What happened to Odisha after R.N. Singh Deo, Harekrushna Mahtab, Nilamani Routray, Biju Patnaik? The state has survived. They were all CMs, some of them headed parties that were breakaway factions of Congress.That is where people who are looking at Odisha from an external viewpoint do not realise that the average Odia voter has always opted for a regional outfit rather than a national outfit.”

(Edited by Smriti Sinha)

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