3 Yr old with egg allergy, CMPI and soya intolerant. Advice on giving a balance diet needed, getting no where with GP

[WorriedAboutNutrition]

My 3 year old DD is allergic to egg, since she was first weaned. Since then we have had CMPI diagnosed, and just recently she is now soya free too as it was causing chronic diarrhoea. We were also advised not to let her have peanuts, just in case so she hasn't ever had them either.

We are due to go for her to have some bloods taken to test for Coeliacs and I am pushing to see a dietician but my GP keeps saying things like "as long as she is eating something you don't need to worry, toddlers can survive on just crisps and bread at this age" which makes me

I'm worried about her getting a balanced diet, I doubt she is getting enough calcium or protein. She was having soya milk and yoghurts, the calcium fortified ones but can't now and the GP said not to try oat milk or rice milk or the other alternatives.

She is a bit of a fussy eater, particularly with meat. She won't eat cold cut meats like sliced chicken or ham. Really only minced beef in a bolognese, sausages (usually make a casserole) and breaded chicken and fish fingers.

She will eat any fruit and veg, loves them. She likes bread and rice but won't eat pasta. She'll eat potato as mash or chips or waffles but not just as a plain potato.

I find things like sandwiches really tricky now, can't have cheese or egg, won't eat sliced meats or marmite. What do I send in her lunchbox to preschool?

I'm worried I'm not giving her what she needs. I keep asking for advise from the GP but its like banging my head on a brick wall, I'm getting nowhere. Should I be giving her some supplements?

I've asked to see a dietician but GP keeps saying well we can arrange that if we need to. I think we need to!

Sorry its turned into a really long OP, I'm just really bothered about it and I don't know what to give her for the best.

worried, this is somthing that I have worried about with my DD who is allergic to milk, eggs and nuts. However, from what you have posted, it shounds as though your DD is having a very balanced diet. I personally wouldnt worry too much about variety, so long as your DD is getting a mixture of the different food groups, which it sounds as though your DD does get.

A referral to a dietician was automatic for us through my DD's consultant - are you due to go to an allergy clinic anytime soon?

Why is your GP advising against oat milk? You can buy calcium enriched oatly which is lovely (we use soya but did use oatly for a while before my DD was 1).

For lunchboxes - now I am just thinking off the top of my head, based on the things that I put in my DD's lunch bag to go to her childminders. My childminder can heat things up so I put beans/pasta/baked potatoes in too but what about...
sandwich/roll with vitalite and jam;
sandwich/roll with tuna and egg/dairy free mayo;
sandwich/roll with banana;
or even just bread/roll and vitalite;
finger veg like cucumber, baby corn, carrots etc
cous cous salad
fruit pots (like yogurts but fruit)
Jelly pots
Fruit loaf with vitalite (we use warburtons, not sure if it is soya free, sorry)

Other people will probably have better ideas, especially mums with kids allergic to soya too. If I can think of anything else I'll come back. What I would say is, dont worry if your DD is just having a rotation of the same things in her lunck box - she wont mind so long as she enjoys what she is eating.

Harverina Thanks for all those ideas. I'm just on my phone but I'll have a proper read through tomorrow on my laptop.

No idea why GP said not to try other milks yet, it means she just has toast for breakfast now, no cereal without milk.

Thanks again, will check back in the morning.

No probs, my list is pretty dull, sorry, but all easy. For breakfast you can make porridge with water, its actually quite tasty - nice with sliced/chopped fruit on top. Muffins and fruit loaf could be a breakfast alternative.

You've got a real problem there! oatley is not suitable before the age of two. Rice milk is not suitable before the age of four (carcenogenic). Your GP sounds very worrying to me. See if you can see another. You should push for a referral to see a dietitian. Don't be put off! I have blogged on milk substitutes and getting calcium in your diet if you want to take a look
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chickpeas are a good source of calcium - would your little one eat houmous with breadsticks? I have a pasta made with chickpeas (from the chiller cabinet in Waitrose) by del Uglio. I think it's actually more tasty than normal pasta. Maybe your little one could have it with spag. Bol?

meanwhile my little one doesn't like sandwiches either - not sure why. someone I know uses flatbread with the filling rolled up then cut up, but my baby won't touch those. Thankfully, i'm at home with her so I usually cook something at home. For when we go out we use a Thermos food flask to take preheated food. (apain, I know, but what can you do?)Usually chopped up omlette made without milk but with potato (like a spanish omlette) and mushroom. Or we cook freefrom fishfingers and hash browns.

Hope this help, if I can think of anything else I'll let you know.

Tbh, I think your GP is being an unbelievable arse; you need a dietician referral and I'd be pushing for one by any means necessary. See a different GP, track down your old HV, call up the hospital and see if the dieticians there do self-referrals. It IS possible to have a good diet given those restrictions, but taking out soya is a big step because so many of the fortified dairy substitute type things are soya-based.

The dietician has the maths of what contains what, especially things like calcium. Fwiw, there's a fair amount in leafy green veg, and a surprising amount in tahini which you can have on toast like peanut butter.

Tbh I take the view that if any child is on a restricted diet, it can't hurt to give a daily multivitimin (DD1 has bog-standard Boots kids' ones, but read the labels as eg the Asda brand has dairy) and possibly the dietician would prescribe a calcium supplement as well. Better to get it through food, but no harm in belt and braces.

How strange that the GP has said not to try other milks. Rice milk is not suitable as a main drink under 4 as the levels of arsenic are too high. Oat milk may not be suitable because i think it cant be technically classed as gluten free, but if she's eating bread it seems pointless to avoid oat milk. You could give cereal with apple or orange juice in, but I would think a splash of rice milk wouldn't hurt.

You could give pâté, tinned tuna or salmon sandwiches, what about chicken and sweetcorn with egg free mayo? DS likes pizzas made with a wrap as the base with olives sweetcorn and tuna with no cheese obviously. Pitta bread with humous. Soup in a flask.

In terms of calcium, green vegetables like broccoli are good. DS will eat them in soup or hidden in bolognese. Fish with bones in such as sardines and anchovies. Sardines could be given in sandwiches or on toast and anchovies can be hidden in tonato sauce for pasta as they break down. DS gets most of his from fortified oat milk. You really need to push for a dietician referral to get the milk issue sorted out.

Oh and you can get an egg and dairy free mayo that is not soya based in health food shops. It's based on pea protein.

You can also get rice yoghurt type desserts from websites such as dietary needs direct. Worthenshaws do a dairy and soya free ice cream, some of the supermarkets stock it.

My dd's consultant didn't mention us not being able to use oat milk prior to the age of two - we were not using it as a drink, mainly for cooking sauces, breakfast etc.

I think what she means is it's not suitable nutritionally as a replacement for cow's milk under two in that you will need a specialist formula or to keep bfing, but it can be used in cereal etc, rather than not suitable at all.

Is there some way you could afford a private dietitian/nutritionist ? Your gp sounds horrendous he should be helping you ensure your dc I'd getting a healthy balanced diet not fibbing off with the bread and crisps crap. I'm really :( for you.

Someone on MN also suggested under another thread the pig in the kitchen website. It's got loads of recipes for any combination of wheat/ gluten, egg and dairy free. The apple cake is delicious. :)

Oh sorry to hi jack again op but I saw a dietician for my dd who is milk intolerant and when I asked about a milk substitue she suggested the alpro soya 1+ which is obviously no good for u but she also said that if that was no good there was a coconut milk that was also suitable. It's KARA coconut milk u can get it in health food shops and some supermarkets. Don't k ow if that helps but just thought I'd pass it on :)

Ask another GP in your surgery to reffer you to a kids dietian. who do you see re the allergies? allergy clinics do have dietitans linked with them.

As for milk replacement, we have tried chocolate flavoured coconut milk with enriched vit D and cal calcuim. can be plain as well. might be worth trying.

Thanks for all the replies, I'm feeling better that it isn't just me being an over precious mother and others think that we should be getting more support with this.

Sorry, this will be a long post!

We haven't ever been referred to an allergy clinic, only ever seen the various GPs at the local surgery who are all useless imo.

When she was tested for egg the doctor just said don't give her egg and prescribed piriton. We've had a few slip ups where egg is in something and we hadn't realised but we have managed to keep her away from real eggy egg (if you know what I mean!)

The CMPI was diagnosed through a exclusion diet, she couldn't manage lacto free products without the diarrhoea so doctor said it would CMPI. She had a blood test for which was negative so they said it was an intolerance rather than an allergy.

Now she is having chronic (2-3 times a day and really nasty) diarrhoea if she has soya so they said its another intolerance and to avoid it. I asked what would be best rice or oat milk and the GP said not to give her anything. I was because she was just so blase about the whole thing, like it didn't matter.

Need to go on Tues to get the bloods form to arrange the coeliacs test and then have an appt with another GP early the following week. I think I'll wait until then and go in all guns blazing and ask for a referral.

I just know something isn't right and I have no confidence in anything the GPs say. They say one thing and then say another, anything to just get me out of the door. Its so frustrating. I know she is mostly ok, and getting as good a diet as I know to give her but I just don't know how to best meet her needs.

Sorry, rant about the doctors over, on to food:

Had no idea that chickpeas have calcuim in them. She will have small amounts of humous so will start giving that more often, her sister loves it so always have it in. I can probably sneak them into bolognese and chilli and all sorts.

I give her broccoli everyday, she loves it and would eat a whole plate if I let her, so I'll keep giving that. You should see how much I put in my shopping trolley each week!

I don't think I could get her to eat sardines or anchovies because I can't get her to eat tuna but 'll keep trying.

The big problem is the milk issue. I'll keep her off all milks til I see the doctor just to give her a chance to get back to regular, normal poo again but I'll push him for a referral. After that I guess I'll try our HV though I doubt she'll even remember me.

Just checked and our local NHS dieticians are accessible through medical referral only so we can't self refer, its a shame because that would have been ideal.

I put anchovies in puttanesca pasta sauce and they just melt into it so the kids don't notice.

Seems to me like your DD is getting a balanced diet with plenty of protein, carbs and fruit/veg. I suppose the only thing to be concerned about is calcium and vitamin D, and I agree with the others that you've been unlucky with your GP's advice. Also that Kara coconut milk is a good choice (my DS has had it every morning for the past year -- he's almost 2 now). For a while we didn't use soya and he had Oatley and Kara during the day and hydrolyzed formula in the evening. We also give him a small amount of calcium supplements as a top-up. And Abidec multi-vitamins with Omega 3 to help with the eczema. All this on the advice of our paediatrician.
dairyfreebaby, I think it's going a bit far saying that rice milk is carcinogenic! The FSA advises against giving it to young children as a main milk because of the small levels of arsenic in it, but it's fine (afaik) to use in cooking and as an occasional drink. I'd be very alarmed as a parent if I'd given rice milk regularly to my DC and read your post! Also because the OP DD's diet seems by all accounts to be balanced in all respects except the calcium. Sorry to disagree, especially as the rest of your post has been helpful to me too!

Would just like to add that having read some of your blog, dairyfree I have to admit that your knowledge of milk substitutes outweighs mine by a long shot, but nonetheless I'm very sensitive to messages that increase the worry of already very worried parents with multiply-allergic kids!

Worried I got DS1 referred to the dietician through my HV, not the GP (he too was useless). She then got me referred to the paediatrics.
Still needed strong words from me all the way through; but you know your child best, so keep shouting till they start listening.

Trixy, I have a question about anchovies (or anyone else who knows!) do ou just use tinned anchovies and put them through the tomato sauce, with skin and everything? My DH is a little squeemish about fish with skin, but I would like to use anchovies. My DD loves my homemade veggie pasta which is a tomoato based sauce...Im always looking for ways to change it a little, like adding chicken, different veg, but we always end up with the same old trusted sauce because my DD loves it!

Worried - have you noticed a difference now that you have excluded soya?

Harverina Yes, after about 4-5 days of no soya she went back to normal poo again.

I use the anchovies in a jar, not the fresh ones . They don't have any skin on and they just dissolve into the tomato sauce, which I was a bit disappointed about the first time I made puttanesca!!.

Ah thanks, will give them a go. I like the taste of them, its the idea of them thats a bot offputting, but if there is no skin on the ones you use then I am def going to give them a go :)

Worried, sorry I didnt notice your reply. I would def puch for a referral to an allergy clinic - your DD is showing signs of possible multiple allergies/intollerances which are limiting her diet. A major food group is being eliminated - surely she meets the referral criteria for an NHS dietician?! Is there another GP within your practice that you could see to push for this?

Just to let you know what kind of input we have had for comparison...I have had no dealings with my GP re: my DD's allergies. She had her first severe reaction to milk when she was 6 months old and it was through attending A&E and then the paediatric ward that my DD was referred to an allergy consultant. We were seen within 2 weeks, saw a dietician on the same day, were give contact details of the dietician to call with questions or for a follow up appointment if necessary (I have called with a couple of queries) and are now to go back to see our consultant in 12 months for review even if my DD has no further reactions (it was initially 6 monthly).

HTH :)