TEACHING RESOURCES

Solutions for baby CMPA - tips from parents on how to get your baby seen and treated as soon as possible.

cmpa parent advice treatment diagnosis organic cookery school.png
 

 

CMPA affects between  1.9 – 4.9% of young children and is the leading cause of food allergy in infants and young children younger than 3 years (GP INFANT FEEDING NETWORK), with many growing out of their symptoms by the time they are toddlers. However the journey from diagnosis to treatment (and solving baby pain) can be long and convoluted. 

Many mums start with their Health Visitor or GP, and have to return time and time again to be (eventually) referred to a paediatrian, and dietitian. 

With such high occurences, we thought it valuable to talk to parents who've been through this, and (just about) escaped intact - many of whom have gone on to blog about their experiences and offer support to other families on this journey.

The aim of this article is to illustrate the recurring point that you know your baby best - and if they have any symptoms associated with CMPA, you have a right to expect these symptoms to be addressed as soon as possible. 

We'll be exploring this issue in further depth in our upcoming dietitian-led parent workshop (online on 7th June, book a place here), when Nishti from Nishti's Choice will offer her advice on self-diagnosis tools and resources which will help you evidence your baby's problems to health care professional and get support as soon as possible.

Resources include:

  • Nishti’s Choice - My Baby’s Assessment  (to self diagnose)

  • Nishti’s choice - My Baby’s Symptom Tracker (to show to your healthcare professional)

  • The Milk Ladder Symptom Diary (to help you through the milk ladder)

  • CMPA Food Fact Sheet (to help you check food labels)

  • Alternative Products for the Dairy Free Diet (to help you pan your meals, especially if breastfeeding)

Book your place on the parent workshop here

But now it's time to hear from the ladies who've been through this. 


Emma's story, (from Free From Farmhouse).

It took 9 months to get my son officially diagnosed, despite terrible eczema, frequent doctors visits, a trip to A&E and reactions during weaning. With my daughter I knew from day one but I still had to fight for a diagnosis and dairy free formula. Unfortunately it's such a common story. I interviewed lots of experts for my book about living with allergies, which comes out next year with Allergy UK, and they all know the issues but still have a hard time getting GPs to recognise symptoms. 


Nina's story, (from Non-Ige Baby).

It took (sic) around 28 days for my youngest - he couldn’t lay flat for vomiting, his skin was awful and at the point when he struggled to breathe even when bolt upright he was diagnosed. My eldest is still waiting and she’s nearly 3. Luckily she’s able to drink oat milk and is willing to take supplements! I don’t think she’ll ever get any help if I’m honest- it was a battle with my son when the problem was plain as day to everyone who saw him.


Becky's story (from Incredible Isla)

We (sic) sSelf diagnosed after 5 months. Immediate dietitian referral who has been amazing in helping us through multiple severe food allergies .


Laura's story (from Five Little Doves)

 

(It took) 12 months with my first daughter and 9 months with my second. My second daughter was in and out of hospital for 9 months before they finally took it seriously and ended up really unwell. I wish I had pushed harder.


Sarah's story (from Mummy Cat Notes)

It took six months to finally get a diagnoses with my son, none of the doctors believed me and I had to change his milk that was recommended to me by a friend to show that milk was effecting him and they finally accepted it. it’s shocking how it’s one of the most common childhood allergies but no one believes it. 


Laura's story (from Edinburgh With Kids)

It took (sic) 14 months here. After an initial hospital visit at 3 months due to a lot of vomit, we were in and out of doctors visits as she went from vomiting and weight loss to chronic constipation, finally got referred to allergies at about 9 month but another 5 to actually be seen. 


 Zoe's story (from Mummy and Liss).

It took months for me to get a diagnosis for my daughter, I knew it was more than 'just colic' and I was right. In regards to speeding up the process of a referral.. just keep on at them, it sounds bad but do not back down or you will be turned away.. hang in there & just know that you're not an annoyance,  you're doing what's best for your baby  


Lauren's story, (from Dilan and Me).

 It took several months here. My little boy was sick all the time (actual puddles of sick everywhere we went), then his weight gain flat-lined. He fell below the second centile and was diagnosed as “failure to thrive” but no one knew why. I began to suspect CMPA as a friend's baby just had that diagnosis. At 6m we started BLW and he had some chicken cooked in a cream sauce, then immediately came out in hives everywhere it had touched. Luckily he hadn’t ingested any. We both cut out dairy and soya immediately (I was Breastfeeding) and his sickness stopped, and his weight shot up. So basically it was completely diagnosed by myself with very little healthcare professional support. I was dairy and soya free for 2 years until he self weaned, and he’s very very slowly progressing up the milk ladders now at 4.5. 

I advise mums to research as much as they can for themselves, and to read the MAP guidelines which health care professionals should be following. Unfortunately you have to be quite pushy and really advocate for your child to get the support you/they need, but I find showing a GP the guidelines in black and white tends to get them to act and actually refer you to wherever you need. For breastfeeding mums in particular a dietician referral is recommended because it’s important someone is monitoring their diet too for all the correct vitamins and nutrients x

Lauren has created a really helpful Dairy and Soya Free Treats list (perfect if you are breastfeeding).


Samantha's story (from Serenely Sam)

 It took around 4 months for my daughter to be diagnosed. I know thats a lot faster than some but it was only thanks to my amazing health visitor. My GP was very dismissive and wouldn't listen to any of my concerns about my daughter's symptoms. She was being sick all day, explosive nappies all day, she was writhing in pain during every feed, had blood coming from her bum on a few occasions, and also had reflux. The GP refused to look passed the reflux, even when she knew that CMPA ran in my family! My Health visitor's hands were tied really as I had to go through my GP but when the GP wouldnt help, and my daughter was so ill, she referred us to a dietician herself as an emergency case. My daughter was prescribed Similac formula which immediately helped her. 


Nathalie's story (from The Intolerant Gourmand)

My son had a severe allergic reaction and was rushed to A&E at 8 weeks old. But it took until he was 16 months old, and 3 further severe allergic reactions where we almost lost him, before he was finally diagnosed with multiple severe allergies, including CMPA! 
I now work with a number of clients creating allergy safe recipes, lecturing with leading Paed Consultants at various conferences across Europe to help them better understand the impact of diagnosis and the time taken for diagnosis, and coach parents and children to help them to live positively with allergies.


Don't forget to join us on 7th June 2018, for our live parent/dietitian workshop. Tickets cost £10 and are limited in number.

Thank you to all the bloggers who shared their experiences in this post. Please check out their websites and let them know we sent you :)

Ask the expert - we talk to an oral health expert about the best ways to look after your family’s teeth and avoid child tooth decay and extractions.

GUEST EXPERT Q & A CHILD DENTAL HEALTH THE ORGANIC COOKERY SCHOOL.png

The dental health of children, including issues such as tooth extractions and decay are currently making headlines for all the wrong reasons. Numbers of child tooth extractions are up, causing what must be for many children, a great deal of unnecessary stress and discomfort, as well as putting additional pressure on the NHS.

Hospitals extracted multiple teeth from children and teenagers in England a total of 42,911 times – 170 a day – in 2016-17, according to statistics obtained by the Local Government Association

As a parent, and someone who spent a lot of time in the dentist’s chair from the age of ten (due to two broken front teeth rather than cavities), this worries me deeply not only because I know just how distressing and painful dental work is, but also because for most, it is avoidable.

I’d like to think I’m a well informed parent, but these statistics make me wonder just what’s missing in our parenting education, for this problem to be growing so dramatically.

Yes, we need to give our children less sugary foods.

Yes, supermarkets need to stop promoting sugary food.

But as well as dietary choices, how much do parents really know about the best ways to care for their children’s teeth?

As a parent educator, I also know it’s something that other parents lack confidence in too, especially those who have babies starting solids or preschoolers.

Is there enough support and information to support parents right from when a baby starts solids, through to when a child is left to brush their teeth independently?

With this in mind, I decided it was time put some of our parent questions to an expert, and I am very grateful to Samantha Glover, Dental Public Health Program Manager at Public Health England, for taking part in the following Q and A. All questions were submitted by The Organic Cookery School’s Parent Focus Group.

This first question came from Isabel, who like many parents often gives homemade smoothies as a way to boost her children’s intake of fruit and veg (particularly spinach, which as we all know becomes infinitely more acceptable to a child blitzed up with fruit)

Q: Are smoothies really bad? Are they better if drunk through a straw?

A: It is so much better to eat whole fruits; when you blitz the smoothie you release the sugars which can damage your teeth.

These can also be quite acid, leading to enamel erosion. If you are going to have a smoothie or any drink that is not water or milk, drink it with a meal and over a short period of time. The worst thing you can do is sip these drinks throughout the day as it means the damage is continual rather than being in one hit.

If straws reduce the amount of time a sugary drink is in contact with teeth, then yes, but this is reduced if being sipped over a long period.

Find out more on this topic here


Amy wanted to know whether it’s better to offer smoothies at a particular time of day.

Q: Is it better to give a smoothie in the morning (because you can brush teeth after)

A: Give it with a meal and stick to water or milk in between meals. Do not brush your teeth for 45mins after you have eaten or drank anything. Once you eat or drink the sugars and acids in the food form an acid which attacks the enamel. Over the next 45 mins your saliva with help neutralise this acid environment and bring the PH back to a neutral level. At this point it is safe to brush again. If you want to help you teeth drink some water after eating or drinking.

Find out more on this topic here:


Lianne has a toddler and school-aged child and wanted to know how important it is to use toothpaste targeted at different age groups.

Q: Do I really need different toothpastes for all the different ages? Does it matter if my two year old and 8 year old have the same one?

A: The difference in ages for toothpaste is the fluoride content. Children from 4 years old who are developing their adult teeth benefit from the higher dose of fluoride (1450ppm). This is the same for all children older than this. With children 4 and above use a pea sized blob. Children under this age use just a smear. Rub the toothpaste in to the toothbrush so the child doesn’t just suck the paste off the brush and swallow it.

Find out more on this topic here:


Lianne also asked about mouthwashes targeted at children.

Q: Do my children need to use children’s mouthwash?

A: Children should not need to use a mouthwash unless recommended by their dental professional. After brushing the teeth for two minutes with a fluoride toothpaste spit out the bubbles but do not rinse. You want that fluoride to soak in to the enamel to help keep it strong. If you rinse with water or mouthwash you will wash all of this away. The child’s saliva will slowly  wash this away once it has done its job.


Monika wondered about whether toothbrushes need cleaning.

Q: Should I clean my child’s toothbrush (eg sterilise it)?

 

A: No, toothbrushes should be replaced regularly. Every three months is recommended but if yor child has been sick or been unwell replace the toothbrush before. Use a toothbrush cover once the brush is dry or keep them in a cupboard. Do not use each other’s brushes. It is always best to replace than try and sterilise or disinfect a brush. Just rinse the bristles well after use and leave to try.

Find out more on this topic here:


Inga wondered about the effects of dried fruit on teeth, especially as a playtime snack or at lunch.

Q: Can I give my children dried fruit snacks during the day?

A: Dried fruits such as raisins are very concentrated sugar and stick so they stay on the tooth surface for a long time. Try to limit snacks to two a day (100cals) and drink plenty of water after a snack to help clean the mouth.

Find out more on this topic here:


Ines posed a great question about foods that might help neutralise sugar acid during the day.

Q: Does cheese (or any other food) neutralise sugar acid?

A: Yes to a degree. Low acid and sugar snacks include rice cakes, cheese and milk. These can be a good addition to the diet and water and milk are a good option after something acidic or with sugar.  

Find out more on this topic here:


Chloe, one of our ‘Cooking for Baby’ mums asked about babies and teething.

Q: Is it ok to let my baby chew her toothbrush when teething?

A: Teething rings are better for long term chewing but introducing your baby to a toothbrush whilst they are teething is a good idea, they can get used to the feeling of the bristles so this feels more familiar when you start to brush the teeth. Children should be supervised to brush up to the age of 7.


Sam wondered whether her son’s current dental routine was linked to recurrent bad breath.

Q: My child has bad breath, but we clean teeth regularly, are we doing something wrong?

A: Bad breath can be a sign of a throat or stomach problem. Take the child to check that the teeth and gums are clean and healthy. If this is the case then check with your GP.  Often when a child has a throat infection or stomach problem it can cause a bad taste and smell in the mouth.


We also asked about rinsing with water.

Q: Should my child rinse with water or leave some toothpaste in their mouth after brushing?

A: Spit don’t rinse (see above)


And whether Samantha had any specific advice on sippy cups/giving up bottles.

A: Children should be encouraged to drink from a free flowing cup from 6 months. This will help with keeping the teeth healthy as the liquid is not pooling in the mouth and is in contact with the teeth for a shorter period of time. It will also help with speech development as different muscles are used to drink from a cup.

Find out more on this topic here:


9 children’s books to encourage healthy eating

One of our most successful and memorable community cookery programs which ran in many children’s centres, libraries and infant schools, used books and storytelling as a starting point to inspire families to cook together. We named the project ‘Fairytale Feasts’ and soon realised the value of storytelling to start conversations with children.

This was expanded to a series of workshops for families with younger children - and the main aim was to encourage healthy eating and trying new and unfamiliar foods.

Here are some of our favourite books for younger children which can be used as a tool to inspire younger children to be more adventurous – don’t forget to plan in some cookery as part of the activity. It will reinforce the message and gives them a chance to surprise you and them with what they will try.

 

Toddler Portion Sizes – Ideas and Strategies to Ensure Your Toddler’s Diet is Balanced and Varied.

Toddler Portion Sizes - the Organic Cookery School

There’s no doubt that when babies become toddlers, everything changes – they’re more mobile and engaged, their motor skills are developing at a rate of knots and whether speaking just a little or a lot, they soon start to communicate their preferences and dislikes to you. And that includes what they want to eat.

The Organic Cookery School offers a number or practical  courses which support parents in the next stage of meeting their child’s changing nutritional needs. As well as recipe ideas, these courses are as much about how to deal with the challenges you may face and how to get your child’s relationship to food off to the best possible start.

So how much and what should my toddler be eating?

Whatever our age, we all need variety and balance in our diets, to ensure we are getting the right mix of nutrition. Toddlers tend to have smaller tummies, so appropriate portion sizes are important to make sure they aren’t filling up on just a few food types:

The amount of food your child will want to eat at any given time will depend on so many factors – are they having a growth spurt? Have they just done a big poo? Are they tired? How much exercise have they had today? So offer small portions and top up with seconds, if they are still hungry.

 

Each meal should offer a mix of the main food groups:

 

Starchy/Carbohydrate rich foods (up to 5 portions a day)

The Organic Cookery School Toddler Portion Guide Carbohydrates

 

 

Fruit and Vegetables (aim for at least 5 portions a day)

The Organic Cookery School Toddler Portion Guide Fruit
 
The Organic Cookery School Toddler Portion Guide Vegetables

 

Dairy/calcium rich foods (aim for three portions a day)

The Organic Cookery School Toddler Portion Guide Dairy / Calcium

 

Protein foods (aim for two portions a day, or 3 if vegetarian)

The Organic Cookery School Toddler Portion Guide Protein

 

 

Over the next few blog posts we’re going to explore each food group in more detail and give examples of recipes which are perfect for toddler tums. 


Recipes:

Our Cheesy Spinach and Apple Muffins are a great mix of dairy, veg, fruit and protein and a hit with our little foodie testers.


A note on drinks and what foods to avoid:

During the day time, your toddler will need to remain hydrated and water should be offered frequently from a cup or beaker. They can also drink full fat cow’s milk from one year and need approx 300ml  a day. Squashes, sweetened juices and fizzy drinks should not be given to children and can impact dental health. We have created some toddler friendly whole fruit/veg smoothies, which are a great way to boost your families’ vitamin and mineral intake, but bear in mind that, like milk, they can be quite filling. Try a small (150ml) portion of smoothie at breakfast with some toast and scrambled egg for a great start to your toddler's day.

Avoid, raw or very lightly cooked eggs, high salt foods (or the addition of salt), whole nuts (until the age of 5), low calorie or diet foods, raw fish or meat (eg sushi/steak tartare).

 

The Organic Cookery School Toddler Portion Guide