GP has told me to buy Cow and Gate Pepti - nearly £30 a tin - can this be right??

[Janus]

I don't know if he thinks I'm being difficult because we had Pregestimil last week and she won't touch it so I requested that we try a different type of formula and suggested (as some of you have said it tasted almost normal!) I try Pepti. The surgery rang today to say that I can buy it anywhere and to go and get it myself. Well, I can't buy it 'amywhere', have to order it at local pharmacy and they have told me it will cost near to £30 and this is for 900g which will last me about a week.
Do I really have to pay £120 a month?? Seems mad to me and I have rung surgery to ask if I really have to pay and got the feeling the receptionist thought I should. Gulp!

How old is your child? Do they have a diagnosed allergy? If they are soley on a milk diet and not taking feeds then this is obviously dangerous and I would maybe bypass the unhelpful GP and take them straight to a&e to see if you can get a script for pepti or another lactose free formula.

It also looks like it sells at abot £13-£15 a tin so your chemist is quoting a HUGE mark up.

She's one tomorrow! We are waiting for an arranged appt which is in about a month with an allergy specialist. So far it is just the HV and me who tried to work out why she had such appaling nappies and has dropped from the 75th centile to nearly the 9th centile. GP agreed it could be milk protein intolerance and so prescribed pregestimil but dd3 obviously thought it was vile as wouldn't touch it. She does eat quite well but I think because she is pooing so violently she's not hanging onto the goodness and so not putting on weight perhaps quite as she should. Saying that, I produce tiny ones (!) dd1 was on 0 centile for months!, dd2 never much above 9th, sometimes 25 centile. I think dd3 is destined to be small but the nappies tell me there is something to worry about, just a gut instinct so far.
I just wanted to do something as the appt is a month away and I wanted to try something before then to try and help her. Maybe I should just wait and carry on with normal formula until she is properly diagnosed.

You can order online for just over 17 pounds with delivery. www.westons.com/acatalog/Online-Catalogue-PEP91A.html

Losing weight like this could be gluten intolerance so you could try avoiding wheat temporarily although that would screw up tests at your appointment.

Why not try again mixing the pregestimil with other milk until she's used to it? Or as she's nearly one you can try lactose free milk.

if she is one can she not have normal cows milk now?

sorry, missed the allergy part of your last post

I would make sure that you had a pediatric referral and a proper diagnosis before changing anything. Are you waiting to see a paediatrician?

Hi, we are waiting to see someone at the 'children's and adolescent Medicine Clinic' not sure what this is and if I see a paeditrician or a nurse. Tatt, we're still not sure if it's allergy to milk protein (apparently more likely) or lactose, if milk protein then lactose free milk won't help as still contains the milk protein. I'm hoping this clinic will make all things clear.
I'm really just stabbing in the dark trying to almost self-diagnose until we get the appt and start the ball rolling. I have a feeling that at first appt they will discuss her history and then refer her on for tests so am conscious that this is all going to take weeks to even start tackling the problem. This is why the GP suggested we try milk free formula now and see if it helps and I agreed it would be a good idea to try and start to help.
Her nappies are really just awful but other than that she seems happy enough most of the time. I'm not too worried about the weight loss as I feel she is finding her 'natural weight'. TBH when she was younger she was bf and I seemed to do this around the clock. This all seems to have kicked in when I gave up bf when she was 10 months. Of course now I wished I'd continued but I felt ready to stop and we have no allergy history in the family so I never imagined this would happen.
Anyway, thanks for the input and actually the GP has written a prescription for a small tin of the Pepti Junior which is probably sensible to see if she likes it first.

Janus if it's just dirty nappies then its unlikely to be an allergy, although it could be an intolerance. Therefore "allergy testing" (skin prick testing/blood test for IgE levels) isn't likely to help.

Milk intolerances are hard to diagnose correctly and tests are rarely conclusive. The most effective way to test is to exclude and return to the diet. So for milk there isn't a lot of point in waiting a month and your GP was right to suggest a trial of less allergenic formula.

Anyway you now have Pepti Junior. That is a low lactose formula. At the appointment they may want to do a stool sample to look for sugar (tests for lactose intolerance) and I'm afraid I don't know if there is enough lactose in Pepti Junior for a stool sample to tell you anything.

Paediatricians are not always well informed about allergy or intolerance - just read some of the other posts here! Dieticians can be more helpful and some people would say you shouldn't try and test anything without their advice. If you are good at reading labels that is just wasting time.

Whatever the cause of your child's problems -milk protein intolerance or lactose intolerance - if they benefit from being on Pepti Junior they are likely to be kept on it for a time then reintroduced to dairy. If Pepti Junior doesn't help then you may need to see either a gastroenterologist or allergy consultant. If you get to that point ask about a blood test for coeliac to give them more information to work with.

tatt, pepti junior is not a low lactose formula, it is lactose free. Pepti on the other hand is low lactose (20% lactose, 80% glucose syrup). Also, the nappies could be the result of an allergy, as can loss of weight due to malabsorption of nutrients. This is because CMPA can cause GI problems. An allergy is only ever confirmed by observation of allergic symptoms in combination with either a positive skin prick or blood test (though only a blood test can tell anything about the strength of the reaction).

Janus, don't accept the viewpoint of the receptionist, it's not her job to make medical judgements and nor is she qualified to do so. See your GP and if necessary kick up a fuss. The best way to get prescriptions is to find out is there is a locum GP working at your surgery and book and appointment with him/her rather than one of the practice partners. The reason for this is that the practice partners are responsible for the budgetary concerns of the practice, but a locum will be there a few weeks and then leave again. A locum is therefore more likely to write prescriptions for expensive stuff than one of the practice partners.

hi Janus, I've put a lot on the "allergies" site re personal experience. have a read it might help.wink