To think that sometime GPs and health visitors don't know what they are talking about!

[BabyHaribo]

I think DD has cows milk protein intolerance. She's had classic symptoms improved since I've been dairy free.

Saw the GP for advice on formulas and weaning. She said see health visitor.

Health visitors given me a list of milks but can't prescribe them....back to GP!

They have also both used the term CMP intolerance and allergy interchangeably and also lactose intolerance which AFAIK is very rare in babies!

AIBU to think they should be a bit more knowledgable esp the HV?

You're being a bit unreasonable. HVs in particular have no clinical training. Even a GP, not being a specialist, can be forgiven for not being totally au fait with things.

Have you requested a referral for some tests?

Unfortunately imho the majority of GPs and HVs are clueless about allergies and intolerances, especially in relation to babies, it is utterly frustrating! Ask for a referral to a pediatric allergist. We found even some of the pediatricians were clueless. If you are in London, ask for a referal to the allergy team at St Thomas's.

"HVs have no clinical training"...what? They're qualified nurses who've undertaken extra training to call themselves a health visitor.

ok, I phrased it wrong. Not the sort of clinical training that would make them experts in allergies and intolerances.

YANBU in thinking they sometimes have no clue. My GP suggested that the reason bf ds was vomiting was because I never gave him water between feeds

However, GPs aren't trained specifically in infant feeding, so a lot of the time things bandy around before they get sorted. Also, the reference to Lactose intolerance may have been that it is secondary to the CMPA as it may have led to the deterioration of the stomach lining, which makes it very difficult to process lactose.

If you are certain it is CMPA, simply attend the GP and ask him to prescribe Nutramigen, Neocate or similar, don't keep trying to explain this and that, symptoms etc as they revert to 'diagnosis mode' rather than 'solution mode'

Good luck

With GPs its the luck of the draw, My GP was kinda on the ball with DD2, first tried gaviscon to see if it was a reflux problem and then when that didn't work prescribed Nutrimigen milk for her, HV said i had a brave GP as they usually don't prescribe milk until the baby has seen a pead :/ Its been four months since our referral and the appt is next week, that's a long time to leave a baby in severe pain.

Ask for a referral and push them to prescribe a milk, there failing your baby if they don't Also there is a group on Facebook that is for CMPA, the woman on there are full of knowledge and so helpful if you post and ask for advice

YANBU. HVs in my experience are pretty limited in what they're allowed to say and what is considered to be normal practice. Some GPs dont' even believe that CMPI exists, or that it can cause some of the devastating symptoms of reflux that some parents know all too well.

Some of the reflux forums on FB like Living with Reflux are v useful for advice on the whole sphere of reflux, allergy, weaning problems etc.

No tests are do-able for baby with CMPI - you just cut out dairy which it seems like you're doing. If baby is still poorly eg bad sleep, silent reflux symptoms, you do need to push for a referral as untreated reflux isn't great. Neil Shah at Portland changed our life. V good on allergies. Are we allowed to make specific recommendations on here?

YANBU. I also thought HV had clinical training to some extent. I had a horrible experience when bf, HV told me I had plugged duct and sent me away to 'fix' myself, ended up at GP weeks later with a diagnosed breast abscess which needed a month worth of hospital treatment to correct. HV could have/should have advised me better. Good luck, really sympathise with you

I think YAB a bit U with GPs. The clue is in the name - General Practitioner. Often people expect them to know everything about everything.
However I have yet to encounter a HV who was able to help me with any problems I had with DD. That said, they do exist - at the first GP practice I worked there was a fantastic team of highly experienced and really knowledgeable HVs. I do think they are in a minority though.

They're just people like anyone else. Nobody knows absolutely everything!

by the way - Neocate is amazing and sometimes the baby might need it - but it's worth reading up on the different solutions people adopt, as there's a value in keeping bf if you possibly can, of course. i know some folk found it impossible to keep bf as they had to cut out so many things that their diet became impossible - but if your baby's intolerance is not so severe you might be able to get away with going dairy free.

Oh - and remember that most babies (according to our dietician) with CMPI also can't tolerate SOY! so cut that out too! Our baby still gets rashes when I do soy introduction and she's a toddler now.

We had a hard time getting dd a diagnosis for an intolerance to cow's milk. Instead she got a paediatric diagnosis (from a paed gaestroentrologist) of RAP or random abdominal pain which was more than a little bit annoying since it means nothing but at least it ruled out anything sinister. When we went back to our gp he was fantastic and very helpful in terms of the cow's milk intolerance. It was a pity though that DD was FF but I had a lot of problems with bf and that would have been when I could have done with really specialist interventions from HCP so she did not get exposed to the cow's milk so early but unfortunately it was not to be.

Thanks all

I guess it was a bit of a rant. I'm not NHS bashing generally I feel they are fantastic but it doesn't feel very joined up.

Different healthcare practitioners are telling me different thing and feel a but shunted from pillar to post.

At the end of the day my babies in pain/discomfort and i just want to help her

DS1 was allergic to cow's milk - and it was definitely an allergy as the first time he had anything with cow's milk in when he was weaned, he went puffy almost immediately.

The GP (who saw him while he was swollen as I rushed him there straight away) said it was definitely an allergy - she could see by looking at him - so no need to do tests. We got a referral to a dietician almost straight away as I was worried about his calcium intake once he was on solids.

In hindsight, his collicky symptoms were probably silent reflux from the dairy in my diet.

The only problem we had was with a nurse on the children's ward when he was admitted for an unrelated issue. As he hadn't had tests, she refused to believe he had an allergy and wouldn't allow me to request a dairy free menu. By chance, the dietician we were seeing was on the ward to see another patient and recognized us. She sorted it all out, then I overheard her telling off the senior nurse about us not being on her list of patients to see...

GPs in most areas aren't allowed to prescribe formula any more, unless cow's milk allergy/intolerance has been properly diagnosed. Usual route is referral to paediatrician or paediatric allergy consultant if you're lucky enough to have one available.

The slow pace of diagnosis can lead to both distressed babies and distressed parents for months on end. Reflux, silent reflux, intolerance, allergy they're all interchangeable in my experience with people who throw ideas in the air and see which one lands. I know many babies grow out of their issues (my DD grew out of her cows milk protein intolerance by 15 months but her constant vomiting my breast milk until I decided to cut out dairy at 8 months was both worrying for me and upsetting for her)

Lots of babies have feeding issues and I think if they were resolved quicker by more rapid access to specialist help then there would be less PND and I believe more BFing as often it's the worry of not getting enough (tongue tie, latching issues, thrush) that defeats new mums. So mums would be healthier mentally, babies would be healthier physically and less time would be spent by generalists (HVs and GPs) having best guesses which aren't fully informed.

Lots of babies have feeding issues and I think if they were resolved quicker by more rapid access to specialist help then there would be less PND and I believe more BFing as often it's the worry of not getting enough (tongue tie, latching issues, thrush) that defeats new mums. So mums would be healthier mentally, babies would be healthier physically and less time would be spent by generalists (HVs and GPs) having best guesses which aren't fully informed

This is really the point. All my feeding issues for bf were answered with put the baby on bottles of formula and then suddenly nothing else when there were still issues. She was 6 with constant stomach ache when the gp said look I think it is cow's milk. I think infant feeding specialists could make a huge difference to many infants.

Ironically for me another if I'd moved to FF then Dd might have been even worse as I don't have a whole lot of dairy in my diet as it is. But I had to work it out for myself & finally saw a dietician at 13 months by which point I'd work out how to deal with it (no dairy on an empty stomach). However there were many many months of worry and there would have been even more if I'd FF and not been able to do an elimination diet for me. To have her get to 6 with the same problem shows mums aren't being listened to and helped in a way that benefits them and the baby. Maybe my DD grew out of it because I reintroduced it slowly and not on an empty stomach; maybe she'd have grown out of it naturally but you've been given less chance to sort it at an early age which might mean the problems last till she's much older. That's unfair to both you with the worry and her with the stomach cramps.

OP I think because the root cause of all of the problems are different you are being shunted from pillar to post. Such a shame to have all the hassle when you haven't got the confidence any of it is moving you in the right direction.