What help is available out there for identifying food intolerances?

[PickledLily]

DD's sleep has always been rubbish (she's 2), waking up windy, plus silent reflux and she's always constipated. We've kept a food diary, but nothing jumps out. I'm assuming cutting out foods is the only way to identify an intolerance and that there's nothing the GP/NHS can do to help identify the problem?

Was set to try dairy free but she's a milk guzzler and rejects all the substitutes I've given her.

Hi there, you are correct, elimination diet is the only way to identify food intolerances as testing is not reliable or sensitive enough. Cow's milk and Gluten (wheat) tend to be the main culprits but soya is also one too. If you need help in doing this, the best place would be to visit a BANT (British associated of nutritional therapists) registered nutritional therapist in your area.

Myself and my daughter are cow's milk and gluten intolerant, I'm a the therapist and blog about children's health - here's my link on constipation in children and my gluten free /cow's milk free recipe ideas if you're interested:
mydaughterwontsleep.com/gfrecipes/
mydaughterwontsleep.com/2014/04/25/all-bunged-up-is-constipation-making-your-childs-miserable/

In my experience in treating intolerances - it is often the food that your child likes the best (annoyingly!!!). Have you tried rice or almond milk - my daughter age 3 likes both.
Good luck and best wishes

Bearing in mind as you do (nothing personal, Caroline, I'm sure you're fantastic) that "nutritionist" is not a protected term- anyone can set themselves up as a nutritionist.

A dietician might be the way to go......

Thanks for the information Caroline, and for clarifying the term nutritionist, Martorana.

Caroline - we've not tried rice milk - I was told by various sources that the arsenic levels were considered too high for toddlers . I found almond milk very grainy and tickly on the throat, and DD wouldn't go near it. Ditto coconut and oat milk. I think the next suggestion I'd had was to try flavoured versions of these, but wasn't keen to get her hooked on chocolate milk! Also, she seems worse after chocolate (she rarely has it).

Martorana - How would i get access to a dietician, could I get a referral for poor sleep? I'm guessing it would be a trivial reason in NHS eyes. GPs have been pretty unhelpful and resistant to referrals regarding all the other issues.

Ok, just read your blog Caroline. When my previous GP mentioned CMPI being common in infants, he said I'd need to cut out soya AND goats/sheep milk, as these too can cause problems. You seem not to have had the same experience though? Any idea how common it is (in your experience) to be CMPI but ok with goats/sheep milk?

(I did cut out cow's milk, but not goats milk - didn't know this would be a problem at the time - when I was BF DD; there was no relief from symptoms, but then again I suspect DD also has a PTT which could have been a factor for the reflux).

I've been through all this and Dd is now nearly 3. We knew from when she was a baby as she was very poorly and has CMPI and used to not be able to handle soya too. Now she is ok.
Your first move is a GP appointment to ask for a referral to dietician team. Be prepared for them to not take you seriously at all so you may need to mention something along the lines of you are concerned about her weight gain/fussy eating too. Up to you of course, it can just be really hard to get into the system.
It would also be a good idea to get HV on your side via a phone call. They can no longer refer but if you call to keep them in the loop there will at least be a log of you trying. Then as well if your GP is an arse at all then you could ask HV to talk to them too.
The dietician referrals can take time to come through, where I am the wait is 12 weeks for new patients.
In the mean time there are various things you could try. You could go cold turkey on her cow milk and give her a plant milk instead. I know you said she isn't keen, but they are often more palatable warmed up.
Oatly is good for porridge.

DD had a funny tummy for quite some time when she was about 14-16 months. The GP suggested cutting out diary which I thought was quite a big call to make on the back of no tests / evidence. In the end we paid to have allergy testing done privately. They did lots of scratch tests on her arm with diary, eggs, fruits etc. No allergies were found.

Her tummy finally improved when we cut down on oat porridge - she was eating quite a lot of that which had obviously sent her digestive system into overdrive!

Good luck

Thanks everyone. HV visiting for 2yr review this week anyway - they wanted me to just sign and return a form to say all ok and not to visit, but I want all her symptoms logged on the system, like you say TinyDiamond. Not that I expect to get anywhere with them. Last time we saw them (HV was actually an ex-nurse) because she was off her food, running poos, wouldn't sleep, all they could suggest was controlled crying and a doctors appointment. Turned out she had thrush and an ear infection. Grrr.

Is it possible to go private? I have medical insurance that I could hammer if needs be.

I tried oaty in porridge: rejected! Interesting what you say haahooo about the porridge though as DD does eat it most days, but it doesn't appear to have any bearing on sleep/poo.

You could take a look at the joneja allergen chart on intolerant offspring. Sorry cant link...

The allergen chart is interesting. I wonder what it's based on . Little pickle flares up with tomato and used to with strawberry and kiwi.

My dd (currently bf) flares up with tomato, strawberry and fish. Dietician said the three are often seen together.

Careless you clearly know lots more about allergies than I do so I would certainly recommend others to follow your advice above rather than mine.

Just to be clear though we did not decide against excluding diary based on the allergy testing, we simply did not want to take such a drastic step without having tried a few other things - in our case less oat porridge solved the issue and I'm pleased we didn't end up cutting out diary.

Sorry if my post was not clear on that.

Intolerance v allergy - yes, there is lots of confusion between the 2. Interesting about cutting out oats before diary. I'd kept wheat going because DD had a coeliac test and I wanted to make sure she was chock full of the stuff leading up to it; I hadn't thought about excluding it before dairy. Now we've had the coeliac result back (-ve) it might be an easier route to take.

Could you PM me the dietician's name? That would be useful. Although some days I wonder if I'm just over reacting and DD's just a typical 2yo.

Oh, one other thing I keep forgetting is that she's recently come off long-term antibiotics (for glue-ear). Could explain the change from constipation to sticky poos or maybe it's the stomach bug I had yesterday! Is that likely to make a difference and if so, how quickly would you expect to see a change?

Not bossy at all careless, very good to get a comprehensive explanation of allergy v intolerance issues

OP hope it gets sorted soon!

Sorry for the late reply, allergies and intolerance are a complex subject. Carelesstalkcostslives is correct, 'You can only test for IgE allergies ( quick reactions): non-IgE allergies won't show up on blood tests, and can only be diagnosed by excluding and reaction on reintroduction'

I have not personally met a dietician that works on the NHS regarding intolerances (only IgE allergies) so it's interesting that you carlesstalkcostslives have found one that works privately. I recommended a BANT registered nutritional therapist as opposed to just a Nutritionist as BANT registered are regulated by a governing body and have approved qualifications.

I would not recommend cutting out large food groups without some professional help.

With regards to Cow's and goat/ sheep intolerances as on my blog. I have personally found cow's milk is more difficult to tolerate compared with goat and sheep milk. The proteins are larger and more difficult to break down. However, every child is different. The only way to truly know would be to cut all out and introduce one at a time leaving adequate space in between to note any response. Plain live Yoghurt and kefir, due to thier probiotic and fermented nature are generally better tolerated than milk, cheese, cream etc.

Just out of interest - I as a child suffered from reoccurring glue ear - which was eventually linked to a cow's milk intolerance - but did not show on a skin prick test. I'm fine with goat and sheep milk products - though I don't consume large amounts. My daughter can't tolerate gluten - it makes her very grumpy and interrupts her sleep - however she was negative on a coeliac test.

With regards to Rice milk and arsenic. The arsenic comes from pesticides used - I would always chose organic rice milk. In our household we rotate milks - almond, rice, oat, and goat so we get a variety.

I also find experimenting with mixing different milks together to create the right consistency and taste for your child can be useful.

Anyway, sorry for the long post - just a few ideas. I hope you get to the bottom of your DD's sleep Pickledlily.
Best wishesx

That's fantastic to hear carelesstalkcostslive, as when I was going through the whole allergy/intolerance stuff myself there was no help at all on the NHS so I'm glad stuff is filtering through finally.

It's one of the main reasons I trained as a therapist myself, and I'm glad I did because I needed all my knowledge to help my daughter when she was born.

I'm actually meeting with a leading london paediatrician soon to talk about allergies in preparation for a blog post on colic. I know he's a big fan of probiotics and is quite progressive and open minded.

It's difficult with the NHS because of everything needing to be evidence based (which I have no objections too) it just means that research findings takes some time to filter down into General Practice. Which means advice from GP's can sometimes be 10 years behind the research. Frustrating though I love it when I see mum's taking charge of their own children's health and doing the research themselves. Power to the parent!