Cows Milk Difficulties - Paediatric-Nutrition

Carine Henry RD
Nutritional Assessment
Dietary Treatment
Diet-related Conditions
- Feeding Difficulties in Infancy
  
  Feeding difficulties include a range of scenarios where infants are not willing to feed in order to meet their nutritional needs.
- Feeding Behaviours in Early & School Years
  
  Feeding behaviours respond well to a framework of structure, nurture & boundaries, including feeding difficulties, toddler refusal and ARFID.
- Cows Milk Difficulties
  
  Cow’s Milk Allergy affects 1 in 20 infants in their first year of life. It is a spectrum condition, with a wide range of presentations, sometimes difficult to distinguish from other common problems in infancy.
- Gastrointestinal Symptoms
  
  Constipation describes from the slow movement of poo through the bowel, which is affected by body movement, food, fibre and fluid intake, breath, stress & anxiety, repeated illness and the quality of the gut microbiota.
- Disordered Eating in Teens
  
  Most young people comfort eat at some point, we all do, because food feels nice and when we eat, neurochemicals like dopamine are released into the bloodstream, making us feel good. It’s absolutely normal to comfort eat from time to time.
- Eating Well for the Whole Family
  
  Dieting or not sharing foods with other family members, can feel difficult and upsetting at a deep and unconscious level.
Dietary Treatment Tools

Structure Nurture and Boundaries

Carine uses this framework in all the work she does with infants, children, teens and families. She acts as nutrition educator, guide and supporter, providing resources and strategic tools.

Benefits of Diet Diversity

A diverse diet is the single most valuable way of meeting a child’s nutritional needs. The first nutritional need for a child to thrive well is energy.
Blog
Get in Touch

BOOK NOW

Cow’s Milk Allergy A Spectrum Condition

Cow’s Milk Allergy affects 1 in 20 infants in their first year of life. It is a spectrum condition, with a wide range of presentations, sometimes difficult to distinguish from other common problems in infancy such as colic, regurgitation or loose stools. Both immediate and delayed reactions to cow’s milk are more common in atopic families; those with asthma, eczema or hayfever. Delayed reactions typically show up in gastrointestinal tract and skin. Lower abdominal symptoms eg. loose, smelly, bloody or mucus pooh, constipation and painful wind. Upper abdominal symptoms include vomiting, reflux, pain after feeding and feeding aversion or milk refusal. All gastrointestinal features can impact an infants’ enjoyment and willingness to feed well. At least two persistent symptoms with delayed reactions are needed to consider a diagnosis alongside an allergy focussed history.

Structure, Nurture & Boundaries

The difference between Lactose Intolerance and Cow’s Milk Allergy

Symptoms are resolved by the complete exclusion of cow’s milk and its products, for at least 6 months for delayed reactions and up to 2 years for immediate reactions. A maternal exclusion for breast-feeding babies is an effective dietary treatment, and I will nutritionally treat infant/parent dyads in this scenario. Care should always be taken to ensure mums are getting enough nutrition including calcium, Vitamin D, iodine and essential fats to meet their own needs.Lactose intolerance is caused by too much undigested lactose in the large bowel, resulting from lack of the digestive enzyme lactase in the small bowel. Symptoms arise, with loose, explosive stools, sore bottom, bloating and discomfort; very similar presentations to cow’s milk allergy, but a physiological response rather than an immune response; easy to spot with a trained eye!Lactose is a found in all mammalian breast milk, as well as standard formula. Breast fed babies who snack at the breast and get lots of high-volume, lactose-rich fore milk, can readily get symptoms of lactose intolerance. Feeding observation and advice on how to avoid this, whilst supporting babies to feed well at the breast will be helpful. Cow’s Milk Allergy and lactose intolerance can co-exist, particularly when there is severe and persistent diarrhoea and gut inflammation.

The importance of lactose intolerance presentation

Dietary treatment will vary depending on the presentation of lactose intolerance. Lactase enzyme activity reduces with age, and with ethnicity. Peoples of Asian, African and Indian origin, and children as young as 2 – 3 years can lose lactose activity permanently, but this is not normally seen in the UK. Older children and young teens, can also loose enzyme activity, which can be responsible for tummy symptoms and loose stools.
Temporary lactose intolerance the more common in the Northern Hemisphere, and is usually related to small bowel lining inflammation eg. after infection or surgery. A lactose free diet allows the intestine time to repair and for readiness of a gradual reintroduction of dietary lactose.

Paediatric Nutrition

For any general enquiries, please fill in the form with the necessary information. Any information about booking treatments or assessments can be found below.

Nutritional Assessment Dietary Treatment