Aptamil pepti 1 preparation

[Ancv68]

Hi we have just been prescribed aptamil pepti 1 for our 5 year week old for suspected CMPA and I have a few questions as we left our GP with very little advice:

• is it possible to buy over the counter so that we have some spare? The amount we have been prescribed is going to have to be used sparingly/ to the exact scoop and my baby cluster feeds so we usually waste a fair bit of normal formula.
• can you prepare with the tommee tippee machine?
• is it the same as normal formula in that it must be discarded an hour after baby starts feeding from bottle? The tin says discard immediately but she really likes to graze over an hour with a nappy change halfway through a feed.

Would really appreciate anyone’s advice!

Yes you can but it over the counter. You should also be able to order repeat prescriptions though?

Not sure about the Tommee Tipper Machine. I do know that it has different preparation guidelines than regular formula.

Also, if LO has reflux type symptoms you might want to ditch the machine for a while anyway as it can make the formula a bit bubbly which can add to the reflux type symptoms.

If baby's feed takes an hour I would imagine that's ok?

Thank you that is really helpful! Will have a look at where we can buy some spare as we cannot order a repeat just yet, we have been given two tins to try with a follow up appointment in three weeks and it is not stocked very well across pharmacies so would rather have a back up if possible.

Baby does not have reflux, CMPA is suspected as she had mucus/blood specked nappies for a few days and looser stools. Other than that she has fed very well on aptamil and been very content. Something to keep an eye out for though in case reflux does surface with this formula.

Our baby is on Aptamil. Our GP only prescribed one tub at a time. Repeat prescriptions ordered at the point of each pick up.

The first weekend she was on it the repeat prescription wasn’t processed in time, and we ran out. I had ordered some on Amazon (at £30 a tub!!) as a contingency but that hadn’t arrived either. Luckily I k ew my cousin’s baby was on the same formula and was able to get some, but otherwise my options were feed her something she was allergic to, or not feed her. I kicked up a stink on Monday morning and from then our prescription was 3 tubs. Tell them one tub isn’t enough.

I think this is quite poor. Understandably the doctor has prescribed a small amount at first to see if baby takes to it and prevent waste if not, as once you take the formula home the pharmacy won't take it back. Once baby is settled on it (perhaps even before the 3 week appointment) , call up and explain baby is doing well on it, and can they please increase the prescription amount. For a repeat I believe they should be doing about a months worth. Thats what mine had anyway and never had an issue. I get 4 large tins prescribed at a time. Just ask and explain that a months worth is x amount and please can that be the amount prescribed next time for the repeat

I am more concerned about ensuring baby is fed than a little waste (we are talking about a couple hundred grams of formula), hence why I have asked if I can purchase independently of the GP so that we have some spare. What is poor is that the amount prescribed will get us through one week, not three, with a long weekend approaching and limited appointments available or Doctors around to speak to. We will of course be calling to ask for more but this was all discussed in a rush in our 6 week check.

I don’t think the intention was for the 2 tubs to last 3 weeks, just that it can take 2 weeks to have an impact. It’s standard for follow up to be 3 weeks for this reason. They will expect you to call and order more (on prescription) when needed.

They are stingy though with prescribing and won’t give you too much at a time, and usually you can’t order formula directly with the pharmacy as a repeat, we have to call the GP every single time. Very frustrating as she’s not coming off it any time soon. One tub lasts ours 4 days (she’s been on 8oz 5 times a day since she was just a few months old!)

Op I was saying the doctors is quite poor for issuing a small amount. Understandably you are more concerned about feeding your baby than waste. It's quite simple in that if the doctor hasn't prescribed enough to last more than a few days then you need to call and ask for more! You won't need an appointment the receptionist should be able to put the request on the duty doctors list and have it sent to your pharmacy that day.

Ask to be referred to the dietician so they can alter the prescription to 10 tins a week. That's what they did for me and dd

Sorry
@firstpregnancy1 I completely misread I am just a bit overwhelmed by even the most basic of things this week like asking for another prescription and probably needed a bit more from the 6 week check, it was really brief - baby’s weight was assessed by looking at her as the scales were unavailable. I do really appreciate your reply.

You can buy them over the counter but they are expensive around £20 a tin. As you settle on the formula after a 2+ weeks you will be able to increase the amount every few prescriptions. we went from 3 to 6 and were offered 10 as this is the recommended amount for a fully formula baby. We stuck at 6 as I could fit them in the bottom of the pram and this it was less inconvenient to do more trips to the pharmacy that figure out how to balance the tins on the pram!

A couple of the dairy free formulas have probiotics in and need to be prepared cold but the rest are the same as regular formula. I believe pepti is the same as other formula. Some formulas with froth more than others in the perfect prep. If this is the case you can emulate it by doing a mix of boiled water and cooled boiled water. We did 5 scoops with 3oz boiled and 2oz of cooled boiled water for a 5oz bottle for example

Honestly just give them a call and say it's not enough to last the trial period until the next review can they please issue some more. The receptionist should be able to sort it out. Also, I believe that pharmacies can give you an emergency prescription if you run out. It is a nightmare and the processes aren't always straight forward. You'll find your groove with it and it'll be ok! X

How have you both got on overnight @Ancv68?

@CadyEastman she took to it ok for a day then refused it so we made up 50:50 with normal aptamil on HV advice and reduced throughout the week until she was taking pepti alone. She fed on it for a day then yesterday morning wouldn’t wake up to feed, stopped drinking and producing wet nappies so we went back to 50:50. She would take that but developed a small rash and went to A&E as we were at a bit of a loss as to next steps, obviously we don’t want to give her something that will make her poorly, but she also has to feed. I am aware the process can take a weeks but we can only be so persistent, and we can’t be in a position where she doesn’t feed. The A&E doctor prescribed Neocate and told us to mix with normal aptamil which you can’t because the prep is contradictory in that in that neocate must be prepared with boiled water that has cooled for at least 30 minutes. They were not concerned with her small rash, at the moment I’m trying to persevere with 50:50 aptamil and aptamil pepti until I can speak to our GP on Tuesday. I think introducing a third milk is too soon but am pondering over that today. Sorry a lot of detail but it is all consuming.

@CadyEastman worth noting her only original symptoms were blood specks, green mucus type poos intermittently over a few days and no reflux. Pepti has actually caused reflux symptoms as it is so thin but that’s less problematic than her suspected allergy so we will have to persevere.

You can prepare the two milks separately and then combine once made. So make 2oz of neocate and 2 Oz of aptamil then tip together. If you make the aptamil at the same time a boiling the water for the neocate they both should be the right temperature to be mixed together.

The allergy to the milk proteins in the pepti is probably contributing to the feeding refusals as well as the reflux its causing. Persevering to try to get on to solely pepti probably won't be the solution if this is the case.

Neocate will be even thinner so you might need a thickener such as gaviscon, carobel, magic mix or thick'n'easy. You can get gaviscon on prescription or the others can but bought. They do come with the risk of constipation as thicker in means the poos are thicker when they come out we used gaviscon and for the first month or so needed a stool softener too.

@Superscientist thank you we have managed to find some neocate (unhelpfully the paediatrician had written ‘as much as baby needs’ on the prescription, and the pharmacist initially refused to give any). That sounds obvious now when you talk about preparation, I think I was just too stressed to think straight earlier. We are going to start on neocate in the morning so so that she has a settled night and feeds.

I had one on neocate as well as bf. You do have to follow the instructions and not make it with boiling water.
we had carobel as well but she wouldn’t drink it with carobel so just held her upright for an hour after feeds.
I kept boiled cooled water in the fridge and bought a new flask to keep boiling water in. I mixed the two waters together so I got the correct temp water then put the neocate powder in. I could mix it fresh in a couple of minutes

Hello, my daughter just been prescribed aptamil pepti 1, but I forgot to ask if I should switch completely or 1 bottle per day

I think the advice is to swap completely.

It's usually prescribed for CMPA so if you're still giving regular formula baby will still have all of the symptoms.

If you're unsure, you can always call Allergy UK