Makes Milk with Emma Pickett
Emma Pickett has been a Board Certified Lactation Consultant since 2011. As an author (of 4 books), trainer, volunteer and breastfeeding counsellor, she has supported thousands of families to reach their infant feeding goals.
Breastfeeding/ chest feeding may be natural, but it isn't always easy for everyone. Hearing about other parent's experiences and getting information from lactation-obsessed experts can help.
Makes Milk with Emma Pickett
Breastfeeding and allergies
This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.
Hi. I'm Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself Makes Milk, that was my superpower at the time, because I was breastfeeding my own two children. And now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end. And I'm big on making sure parents get support at the end to join me for conversations on how breastfeeding is amazing. And also, sometimes really, really hard. We'll look honestly and openly about that process of making milk. And of course, breastfeeding and chest feeding are a lot more than just making milk.
Emma Pickett 00:46
I'm really honoured to be joined today by Kaya Thorpe, who is an IBCLC. We first met because we volunteer together with the Association of Breastfeeding Mothers and she is somebody who wears a lot of hats like many people in the infant feeding world. Today I'm going to be talking to her with her ibclc who specialises with families dealing with an allergy hat. She has been involved in infant feeding support since she was a peer supporter in 2014. And that training journey was inspired by feeding her first baby who was born with a cleft lip. Then with her second baby, she had another experience of dealing with faltering growth which led her to carry on training to become a breastfeeding counsellor. And then Kaya's third baby Charlotte taught her the value of specialist support because Charlotte was dealing with 14 different allergies including three that cause anaphylaxis. Kaya formed a charity called the Lowestoft and Waverney Breastfeeding Support in Suffolk. And she's the CEO of that charity, as well as offering home visits in the local area. She also works for an organisation called the milk hub. I think probably at the end, we'll talk about some of these charities and how you're able to offer support for free and when you can and when you can't. But let's not worry about that right now. Because first of all, we're going to talk about allergy. Kaya is very kindly going to let me ask some very, very basic questions today because the area of allergy and breastfed babies is super complicated. And I have no shame in asking those dumb questions. I'm just going to start by highlighting the fact that obviously neither Kaya or I are doctors, were not able to answer questions that are medical and if we ever come out of your remit, Kaya, I'm sure you'll have no hesitation in giving me a poke. Is there anything I haven't said that you think I should say before we get started with my dumb questions?
Kaya Thorpe 02:30
Nothing. Thank you for having me today, Emma.
Emma Pickett 02:32
Oh, it's a pleasure. Thanks for joining me today. You are a very busy lady. So I'm very grateful that you are giving me this time this morning. Let's start with the super basics. I said I had no shame in asking the dumb questions. I'm not kidding. What's going on in the body when we have an allergy. So I know that there are two different kinds of allergy, this IGE response and non IGE response. Just really simple what's happening when we have an allergy? And what are those two different responses what's happening in the body when they happen?
Kaya Thorpe 03:03
An allergy is where your body is viewing itself as under attack from something foreign, your body's going to try and fight it off. And then this reaction occurs. This can occur sort of in line with anything, it can be pollen, it could be food, it can be environment, everyone's going to react in a different way. And everyone's going to see a different reaction. No one will give you something standard. an ideology is where there's an immediate reaction to the allergen. So this, for example, could mean like hives even on contact without ingestion. Ideologies are the ones that show on the skin prick test, and they are the ones that can cause anaphylaxis. So non ideology is where you will see a delayed reaction. And it can vary from be hours or it can be days, they are not as severe in that they're not as dangerous. They're not going to cause an anaphylaxis, but they are no less uncomfortable, particularly in a small baby, and no less distressing to deal with.
Emma Pickett 03:59
Yeah, yeah. And obviously difficult for parents that you're supporting. So So Charlotte had anaphylaxis. So that means she had the egg e response or sorry, an IGE response. Why am I saying ag I don't even know what to say. So, that must have been scary. And I'm sure that gives you a real insight into how parents are dealing with allergy and gives you empathy and your work which must be super valuable. Am I right in thinking that cow's milk protein is the most common allergen when you're working with families with babies? How much of your work is about cow's milk protein allergy?
Kaya Thorpe 04:32
Yet cow's milk protein allergy in under ones is the biggest general reaction and is the one that everyone will always suggest first, it's more common in a baby receiving formula milk than it is breast milk, but it is still existence. A lot of my work yes does form around cow's milk protein allergy, but actually a lot of the time I'm working with families who've perhaps already removed the cow's milk protein from diets and Still struggling and picking up those sorts of families. But it's a really kind of big, big thing at the minute cow's milk protein allergy. And we're seeing a lot of babies struggle.
Emma Pickett 05:12
Yeah, yeah. And that's just this is a dumb question number two. cow's milk protein is not the same as lactose intolerance. This, I sometimes see parents on forums who are confused about lactose intolerance. And we sometimes hear health professionals who are a bit confused about lactose intolerance. So can you just clear up for us? What's the difference between cow's milk protein allergy and lactose intolerance?
Kaya Thorpe 05:33
Yeah, so cow's milk protein allergy, so CMPA, where the baby is allergic to the protein part of the cow's milk. It is confused with lactose intolerance a lot, as you've said, but lactose free foods will still contain the protein part of the milk because the lactose is the sugar. So a lactose intolerance is where your body isn't producing enough lactase to digest the lactose in your gut. Lactose being the sugar, human milk is approximately 98% lactose. And so primary lactose intolerance is going to be picked up really rapidly, because it will potentially be life threatening. Secondary lactose intolerance can develop in sort of an old baby or a toddler after a sick bug or illness. But this is something that's temporary. It's one of the things that really gets to me as an ibclc, when I've seen a family who have CMPA. And they've been told it's lactose, and they've gone lactose free. And it's just prolonged the suffering because obviously, they're still eating the cow's milk protein. Yeah, which means things are just getting worse. And obviously, from a formula perspective, GPS don't generally prescribe lactose free formula. And it's, it's really expensive. And, you know, we're in a cost of living crisis family shouldn't be paying for an inappropriate formula that is very expensive,
Emma Pickett 06:46
Yeah, and if you're breastfeeding, you physically can't take out the lactose. So the idea, I've heard people on forums on Facebook, say, I am going lactose free, because my baby has a dairy allergy thinking that they can take the lactose out of their human milk, which is, so lactose has nothing to do with cows. It's the sugar that all mammals are producing in their milk. And it can't be taken out, you can't remove it with your diet. So if someone's saying your baby has lactose intolerance, we just need to double check that they have full knowledge that they're talking, they know what they're talking about. Because lactose intolerance, as you said, for a young, tiny baby from birth, they're gonna immediately be extremely ill, we're talking about very, very rare metabolic disorders that will mean lactose intolerance and a new baby. And that secondary lactose intolerance. We'll talk about that a bit more in a minute. But that, as you said, it's temporary when it does happen. We used to talk about well, this is when I first started training, we talked about intolerance, and CMPA. And then CMPI, is that still a thing?
Kaya Thorpe 07:47
No, we've tried to we've moved away from that now. And that's where you see these IgG and non IGE classifications. So an IGE allergy is what we always did call an allergy. And the intolerance now actually is called a non IGE. allergy. Okay, I actually think it's really important to recognise it as an allergy, not an intolerance. It's just the language we use when we're working with dyads. Because an intolerance and non IGE allergy is no less distressing for the parent to deal with. And it's validating to be told that your child has an allergy, as opposed to, oh, just a bit intolerant. And I that's something I really think is important as we work with these diets to just really validate what they're going through and the emotional stress and distress.
Emma Pickett 08:36
Yeah. Okay. So we sometimes have adults still talking about gluten intolerance. That's I guess that hasn't that message doesn't necessarily filtered into the adult world. But is an adult with a gluten intolerance is that someone who has a non IGE response to gluten is that would that be valid? Or we just can't say that for sure?
Kaya Thorpe 08:54
I obviously, generally only work with the little ones, from personal experience can say that, yes, I've been told I am intolerant to a few things. And you can be lactose intolerant. Obviously, as a human race, none of us are actually designed to process lactose. And some of us just don't cope with it as well as others. And people will choose to live with the fact that they might struggle after eating a large amount of dairy and they're quite happy to live with those side effects. From a baby perspective, which is obviously where I sit very much we stick with the IgG and the non IGE classifications.
Emma Pickett 09:28
Okay. So your comment about as a human race, you mean past infancy past the age where we drink breast milk, adults start to form lactose intolerance. That's a quite a common pattern, isn't it? There are a whole chunks of the world where lactose lactose intolerance is the norm because, you know, people don't tend to hang on to those enzymes. And whereas in the West, we carried on eating dairy and milk beyond, you know, our breastfeeding years, which is why we think it's normal to do that, but it certainly isn't everywhere everywhere in the world, for sure. So let's talk about the families that you work with. So what sort of symptoms do you see in the babies that you support, who are struggling with cow's milk protein allergy?
Kaya Thorpe 10:09
So it's really varied. And I think this is one of the difficulties in unpicking allergy babies. As a standard, you're going to see potentially in a human Milford baby, they might struggle with skin issues, they might be sort of quite reflux. See, they might not gain weight, well, they might poo frequently, they might not poo. Generally, in a human milk baby, I tend to find it's more common that they poop more frequently as opposed to struggling with constipation. These can be really low level symptoms where it's a niggle for the parents and they're monitoring when a baby is purely fed human milk.
Emma Pickett 10:52
Can I just ask about the skin symptoms card? Because I think lots of people think, Oh, my baby's got little white spots on their nose, is that a dairy allergy? My baby's got acne, is that a dairy allergy? When we talk about skin symptoms, what are we actually looking looking at?
Kaya Thorpe 11:06
So we're looking at Yes, obviously, all particularly newborns have that lovely spotty stage that we all know. So well around about three week mark, we're really looking at skin that's not settling that's angry that can often be quite red. You may see even in a tiny baby that they can be sort of visibly uncomfortable, they might be quite regularly fidgety. As they get older trying to get it their skin, it might be rashes that bleed that go or finding colour. It doesn't generally link hand in hand with things like cradle cap, or things like standard, sort of the newborn milk spots, as they're often known as the little white spots, which should clear up themselves with no treatment is when it's prolonged. When it's worsening, the older the baby is, things like that we're really worried about x MyStyle. rashes, sometimes incredibly dry skin can be that first sort of indicator, but it's really different per baby, there's no set like oh, it's got your baby will do this, to do that. And it's always important, obviously, to check with a medical professional, but you're trying not to be too worried if your baby's got things like the standard milk spots which disappear or cradle cap even if it is quite challenging. And when it really starts to get to the point where you you feel your baby's in distress and uncomfortable, those sorts of rashes.
Emma Pickett 12:28
Okay. And then when it comes to, you talked about weight gain being compromised, and correct me if I'm wrong, but my understanding is, if a baby has an allergy, their gut is likely to get damaged. And we need the gut to be efficient at absorption to be able to absorb those calories to convert those calories into weight gain. So if the guts damaged, we're likely to see weight gain being affected, and that gut damage is also going to mean unusual stools as well. So we're not just talking about frequency of poo. We're talking about what that pool looks like. What would you how would you describe a sort of allergy baby poo? If let's let's assume that the baby is breastfed or or vast majority breastfed? What does that allergy pool look like quite often.
Kaya Thorpe 13:08
So generally, you will find that they are often green, and it can be quite a dark green, it might be quite mucousy and slimy. One of the tests I always talk to parents about is after their baby's pood is, is putting the nappy together and stretching it to see if there's mucus or if there is actually just sort of the strings that are standard within a human milk fed poo. There can be blood in the stools. And it's always important if there is blood in the stools to get that baby immediately checked. Because it can be done to sort of just a baby who struggled to steal at that point. But always get checked, they can be quite frothy can be a very odd consistency. They can smell quite nasty, quite vinegary things like that. On weight gain, yes, we can see some allergy babies who struggle with weight gain. But it's also really important to recognise that there are many allergy babies who because they may choose to feed to soothe their pain actually gain weight beautifully. Charlotte was one of those babies gained weight. Once we worked out she had an allergy and we remove some formula that we've been using because poor weight gain thanks to an early tongue tie. She did then gain weight beautifully, but she was a very miserable baby. And as a parent, it's really heartbreaking to hear and family say of my GP won't do anything because they said the baby is gaining weight well, and I always think that's a really big one. And often I'll see babies who are mistaken faltering growth as an allergy and put on the allergy pathway and actually it's a feeding issue. So yes, weight is one of those things
Emma Pickett 14:51
but yeah, okay. So it's a real Sherlock Holmes thing going on here, isn't there? I mean, it's super hard because we've got so many symptoms and they all kind of lattice together. In this quite complicated way, and obviously we've got new parents who are understandably going to be anxious about their babies and worried. So what a one off green poo for a baby that's otherwise happy doesn't have any discrete skin symptoms, you know, where even the occasional regular green poo isn't necessarily a problem in isolation, but you're bringing everything together in a sort of general pitcher to kind of get a history, which is why it's so important for someone to really sit down with the family in the way that you do, and really talk them through everything that's going on. And reflux, tell me about the relationship between allergy and reflux.
Kaya Thorpe 15:33
So reflux is a symptom of an allergy. And it's working out what the level of reflexes. And if it's in conjunction with feeding, it's always important to rule out any feeding difficulties and things like that first, but very often a baby who vomits and this can be anything from those big spectacular powerful vomits that soak the area to just continuous positing and continuous vomiting. The baby may not even appear distressed by the vomiting. And if we had no other concerns, and baby was gaining weight, fine, we probably wouldn't suggest anything. Because some babies are just naturally more sticky than others. It's again, putting it hand in hand with what else is going on. Generally, allergy parents will not be describing their baby as a happy settled, baby. They won't be finding parenthood enjoyable, they won't be finding their baby. enjoyable. They might be struggling with things like that and add in wearing constant vomiting. And you can see where that can then get quite depressing as a parent of an allergy, baby.
Emma Pickett 16:44
Yeah, for sure. So let's imagine you're working with a family, you've taken that long history, it looks like their point it's pointing to a situation with allergy. If that baby is 100% breastfed, what happens next?
Kaya Thorpe 16:58
So I always suggest, as the first step is talking to a parent about what they're eating, often parents don't mention what they're eating. And it's not unusual, especially now to come across a vegan parent and obviously talking about dairy allergy and a vegan parent is of no use to to them about what they're eating. Talk to them about how they feel about doing a dietary restriction. I really hate suggesting a dietary restriction and it for me, it's a last resort because it can be miserable. The first thing to always suggest cutting is cow's milk, if that parent obviously is consuming TASMAC. Now, we've started to see coming through into research. I know this was talked to at the BFI conference, I think last year that not all parents will actually need to cut cow's milk, it will be that there can't be a direct ingestion. And I have started to see some families really see a good level of success with like a partial cut.
Emma Pickett 17:58
That's interesting, because so I very much when I started talking about elimination diets, when I started training, people used to say, you've got to take every single, tiny, tiny bit of dairy out of your diet, you've got to read every label, you've got it, you can't make one accident once. And people used to say you've got to do it for at least four weeks before you can see results. And it sounded in tents. So that's not necessarily what's being talked about now.
Kaya Thorpe 18:22
No, we're starting to see it come through, again, lacking in evidence, because we never do get the good research behind, you know, things that impact particularly breastfeeding. But actually, for a lot of parents do a full restriction might not be needed. Yes, for some they will. And for some families, they may just feel more reassured if they know they've cut everything. But I have seen I have a particular dyad at the moment who can still consume biscuits and things right at the bottom. She can do pancakes right at the bottom, but she can't then hit things like pizza. If she has pizza, her baby reacts but if she has biscuits and things like that, the baby is absolutely fine, settled happy. I have other parents where that's not the case. And they do need to cut absolutely everything from their diet. Some parents because obviously we always want it to be their choice their decision. It's an empowering them to make the decision that's right for them. Some parents will choose to very slowly cut it for the sheer ease. Some parents will choose to go straightaway cold turkey. One of the key things that I always suggest if I have a diet where we're pretty convinced we've got a cow's milk protein allergy is that we are minimal on what we introduce from a sawyer perspective, particularly if they weren't having soya before. If you eat a normal sort of meat based diet, the chances are you're not consuming a lot of soya if you're vegetarian or vegan, the chances are you are consuming a higher amount of soya and there is a really strong correlation between dairy allergies and soya allergies. I don't generally suggest cutting two at once, because you always want to hope that this baby isn't reacting to too. But I always suggest perhaps being mindful of how much soy they put into their body and perhaps not doing the direct swap for soy milk from cow's milk and using things like oat or nut milks instead. With timelines, again, it varies on what the baby's symptoms are, it can be quite quick, it can be that you'll see an improvement within a few days. But it will take time the gut needs to heal. If you've got baby where there's a skin based reaction, again, this will take longer to clear and it may sometimes need a little bit of support from specialist creams and dermatology sort of level support. Because it doesn't always clear on its own. So it's, it's really hard. The the new guidance now states that it's a restriction for two weeks, and then it's a reintroduction. Not the six weeks that years ago, we used to say, oh, it takes six weeks, three weeks to leave your milk and it takes three weeks to leave the baby.
Emma Pickett 21:09
Yeah, that's I remember hearing that and thinking, surely those two things are happening at the same time. That seems a bit of a strange one. Yeah. Okay. Well, that's reassuring that parents aren't being asked, because sometimes we used to hear, Oh, you, you know, you're only in week four. Well, that's why you're not seeing any changes, because you need to keep going. So I'm glad that that's, that's being rethought about, which is good news. So sometimes, this is a whole other conversation around, you know, industry involvement and conflict of interest issues. But we sometimes find parents with allergy going to GPS, GPS may not necessarily have the training and lactation, and they're saying, I think you should stop breastfeeding, I think you should use a special formula. And then we'll know what's going on. Is that a story that you're hearing from parents locally to you as well?
Kaya Thorpe 21:56
Not so much locally, in my area, where I'll cover Norfolk and Suffolk with the charity, purely because we actually are really blessed that the head of allergy for the East of England, and he is incredibly pro human milk being given? The so he's kind of got it. Quite well rolled out that it's always breast milk first, and that we support that. In other areas, though, yes, I have definitely seen families where they are told that the answer is to stop breastfeeding, and to give specialist milk or they're told to pump their milk for, say two days and give formula for two days while it comes out of their milk. Which, if you're a parent, and you've got this baby that's in pain, that sounds like the really logical answer, because you don't want your baby to be in pain. No parent goes into parenthood wanting to upset their baby. And it's really hard to know that it might not be, you can't just stop, you know, the case might be in your diet, and you're gonna have to cause distress for a few days longer or when you have a slip up. If you do, there's going to potentially be some distress. And you can see why in the heads of parents that analogy formula can really be quite appealing, but they are challenging to get babies to take. They often have very different makeup instructions, and they're not pleasant.
Emma Pickett 23:18
Okay, so next question. This is where I'm going to need your help. Because it seems as though we're in this weird place where we have both an under diagnosis of allergy in babies. And we also have an over diagnosis of allergy and babies happening at exactly the same time. And I'm really refreshed to hear that you have a local area where health professionals are getting the right information, which is brilliant, because I heard a talk given by Dr. Chris Van Tulika. And and he also wrote an article in the BMJ about how the formula industry is sort of weaponizing allergy for commercial reasons. So in this article, in the BMJ, he talked about how and in 10 years between 2006 and 2016 prescriptions for the specialist milks increased by nearly 500%. And the NHS spending on these milks went up by 700% from 8.1 million pounds to over 60 million pounds annually. And he also described in this too, I also heard him talk about this study day in in London that it's actually difficult to get information about allergy symptoms that hasn't been created by the industry. And lots of the guidance is industry created to I'm not saying everybody is consciously evil because very, very, very few people are but there are people who are dealing with conflict of interest and bias and with the desire to sell a product which means that parents aren't necessarily getting access to the correct information that's breastfeeding supportive. Is it possible to have an under diagnosis and an over diagnosis at the same time? How do you kind of respond to that message from from Dr. Chris that that we need to be worried about what's happening in that allergy space?
Kaya Thorpe 24:58
I absolutely agree that, you know, we're not in a good place in the UK at the minute with dealing with infant feeding and allergies. You know, over the years, you yourself will know as an ibclc. We've we've seen so many problems with infant feeding become medicalized. And on most of our NICE guidelines, it states that before doing anything, a feeding assessment should be carried out by someone with the suitable skill to do it. But it doesn't say who that person is when that person is available. And actually, it doesn't quantify what that skill level needs to be, you know, the NHS is so stretched, we have got some phenomenal health visitors, GPS and midwives out there. But they've got so much to deal with. And it's coming down to the level of training that they've been given midwives get very, very limited training on allergies, you can almost see how we've kind of slipped into this loop of medicalization of infant feeding. And then you hit the other side where we've seen that really increase over the last few years for those of us in the infant feeding world where there's the whole pressure of parenthood, and this perfect baby who sleeps who doesn't cry, don't want to seem too needy. And, you know, we just get back to our previous lives as parents. And I always feel that social media in that respect, it's got a lot for answer for Yeah, you know, combine the two, plus the removal of so much support and education during COVID. And it really does feel like you've got a melting pot at the moment for Formula companies to profit from. There's a huge push on education coming from Formula companies. But we're not seeing that same increase in spending on education for breastfeeding. There really is so little information out there for families to access that isn't funded by formula companies. And formula fed babies are more likely to have a cow's milk protein allergy, but their symptoms may different, you know, and how they behave is not gonna be the same as how a breastfed baby behaves. It's really hard. And I can see some changes slowly starting to come. But it's still so varied across the whole of the UK. Even down to things you know, tongue tie services are varied. And these actually play a huge part in allergy symptoms with things like wind and reflux and frequent feeding. I just feel within the UK, we've lost sight of the whole wide range of normal baby behaviour. And we've moved to medicalizing to solve problems. But you can also absolutely see how a GP or a health visitor or a midwife who's been faced with a distraught parent who's concerned about their baby just wants to help and they want to fix that concern. But if the only training they can access is based around formula and the norms, you can see, again, where we're getting in this state, I'm definitely seeing a huge increase in families being told that baby has CMPA. Yes, sometimes those families are definitely unnecessarily diagnosed. But also what you're not seeing is families who are provided with the relevant referrals, or I'm even seeing babies who are being prescribed the correct formula, and are being told to purchase it over the counter, which is really expensive. We're definitely not in a good place UK wide.
Emma Pickett 27:54
Yeah, yeah. Gosh, it sounds grim. And actually, what you described earlier about symptoms is because there's such a complex group of symptoms, it's actually really hard to train somebody because there's almost a gut level intuition about whether a baby has an allergy sometimes, which is really hard to say, no, come on, come with me for six hours. Let's sit down and do a seminar. And I'll tell you about how breastfed babies behave. And, and it's it really comes from experience. So you need really experienced practitioners to sort of mentor other people into understanding how babies behave and what's normal. And I think what he was saying about social media is really interesting, because I think social media can be the most amazing thing in the world for a parent of a new baby, but can also do immense harm. So I'm seeing parents who are getting down to the sort of micro level is my baby normal is my baby normal. This can't be right positing can't be normal. Wait, you know, when, perhaps a generation ago, we all had burp cloths we all accepted that babies posited. It was you know, a joke that they brought milk down your back, and it was just what happened. But now parents are more likely to do bit of research on Facebook find out that positing can be linked to reflux, which can be linked to, you know, a dairy allergy. And they're starting a dairy elimination diet because they found a reference to how reflux is connected to allergy. And the only thing going on with that baby was was normal positing and we know, you know, 60% plus of baby's good posture every day. And that could be completely normal. How can we help parents to kind of use social media in the right way? Maybe that's too hard a question.
Kaya Thorpe 29:25
It is. It's a challenging one, isn't it? Because yes, social media is both a tool and a weapon. I feel like currently at the minute we're in that milk supply cycle. I feel like I feel like you know, infant feed and breastfeeding goes through almost trends. We have our reflux and our allergy trend. I feel like at the minute we're hitting the, if I don't have a freezer drawer full of of breast milk frozen, I have a milk supply problem. That's what I'm seeing a lot of at the moment, and it's making sure that if you are following something, make sure you're following Something good. You know, there are some amazing mommy bloggers out there who definitely make parents feel less alone in their journey and you know, really validated. But it's remembering that they're talking to you from peer to peer and peer to peer support is just vital when you are a parent, but it doesn't replace that skilled knowledge and understanding and is making sure that if you're following something and you see something that concerns you, you back it up by speaking to a specialist, you know, as always, as a starting point, your local breastfeeding support group, the NBH, the IBM, the NCT, the lavash League, all those helplines are there, and then moving on into sort of speaking to specialised, ibclcs and health visitors and making sure that know that you're not seeing something that you shouldn't, or that you're not reading too much into something or actually that you're not missing something. Because you've written it off as normal. It's really challenging, you know, my consults take anywhere from 90 minutes to two hours. And we're expecting GPS to potentially deal with an allergy Bay, because that's the person who does the prescribing in a 10 minute appointment.
Emma Pickett 31:11
Yeah, it's mad, isn't it? 10 minutes, nothing, isn't you can't even to graze the surface in 10 minutes, use empathy for for GPS, you're expected to do that without necessarily even having the proper training and lactation as well. It's an impossible task. And so parents are inevitably going to be leaning on social media, and I guess the way algorithms work, I would just want parents to be aware that you can get pulled into a rabbit hole of not normal. Because if you spend some time reading about a subject on social media, that's going to be the video you get shown next time, that's the person you're being recommended to follow next time, that's the group you're gonna get pulled into. And before you realise it, you've been sucked into this area where everything is abnormal, and you don't necessarily get exposure to, to normal babies positing or normal babies having green poo. And so we just you just need to sort of widen your scope and make sure you're talking to other people as as well, as you said, finding that specialist as well. So obviously, you're talking to people with allergies, you're talking to families that have allergy, but you're also supporting families who are worried they might have an allergy. And then they spend that 90 minutes two hours with you and realise that they didn't. What are some of the most common normal baby behaviours and normal symptoms that are confused with allergy. So we talked a little bit about green poo, and how green poo can be normal? What are some of the other things that are often confused for allergy and you, and you're often having conversations to reassure parents that they're normal.
Kaya Thorpe 32:35
So particularly with babies that are directly breast or chest feeding, frequent feeding, not settling for, you know, more than 45 to 90 minutes, wanting to be very constantly or being quite grumpy in the evening, those can be really concerning for parents. Wind is a big one, particularly when we hit that sort of three to six week mark, where we know that they can sound a little bit gurgly and they can struggle and they can bring their legs up. That is often a point where we'll start to see parents queering is it something that I ate that's making my baby feel uncomfortable, when actually it's just a normal part of infant behaviour, periods of unsettled behaviour, breast refusal periods can be really unnerving for a parent if they have a baby that randomly will just be crying and not want to breastfeed at that point. And often they their first initial leap is that my babies in pain, I must have eaten something because that will. It always seems when you're only putting breast milk in, it's really easy to put that blame back onto yourself intrinsically. Having a baby. Particularly this is something I will see if I'm working with a dyad who it's not their first baby who is quite high needs. And it's really important to remember that we can just have a baby that's quite high needs. That needs that contact that skin to skin they need to be slung for all of their naps, they co sleep they don't want to be put down. They don't like other people. That doesn't actually mean that something wrong. It just means that they're on the higher end of the spectrum. I know that Catherine Stagg terms is really well with her orchid babies and her dandelion babies and it can be really challenging if you suddenly get an orchid baby having had some dandelions, and they're really difficult to deal with. And it's, you know, personality. Some babies, unfortunately, are just a little bit grumpier than others. And it doesn't mean there's anything wrong.
Emma Pickett 34:31
Yeah, I mean, that evening, fustiness not expecting a baby to cry a big chunk of the day and assuming that must mean something is wrong. This can't be right. This must be abnormal. Because we just don't grow up around babies. We just many of us just don't see babies very much until we have our own baby and, and when a baby's cluster feeding and fussing and coming on and off the breast and wanting to feed after only an hour or 40 minutes. You know, we're just even though all the work we've done on responsive feeding all the work we've done on understanding how frequent feeding can be Normal, it's so easy for parents to slip into thinking something's wrong. And surely my baby isn't sleeping for a block of three hours, there must be something wrong with their gut, there must be something wrong with my milk,
Kaya Thorpe 35:10
there's got to be something going on, is that generational thing at the minute, obviously, a lot of our parents who are having babies themselves, were born in the 80s and 90s. When breastfeeding rates, you know, we're not, we're not high, and our parents formula fed, and we were still seeing a lot of the all the only feed every four hours kind of job. And when your support network perhaps lived with that, and then you're breastfeeding every 90 minutes, there can be a lot of sort of, oh, do they need to eat again, is that normal, and it doesn't take much when you're sleep deprived and tired for someone to plant that seed. And for you to go down that tunnel.
Emma Pickett 35:47
Yeah. And that generation, we're also very big on what we eat makes our baby sad, or you have some sprouts, or you had you had a fizzy drink, you drank some orange juice, gosh, there's a lot of scary myths. But But believing that because you had curry last night, that's why your baby woke every two or three hours, and forgetting that there are entire swathes of the world where that's that's a normal diet for any young family and parents. So yeah, there's, and we get that thing that we were, it's a sort of self fulfilling prophecy, if someone has told you, that is going to affect your baby negatively, you will start to interpret their behaviour in a certain way. And again, if you don't surround yourself with that, that knowledge and that information and and that expert support, you're going to get pulled again into that rabbit hole, which is, which is just as miserable in a way as having a real allergy. Because, you know, you can just get yourself very despondent and very low. And that's why that peer support and expert support is so important. Just to come back to something you said before you talked about skin prick tests and testing. I just want to double check is and tell me if this is wrong? It's my understanding that you can't test a breast for baby for an allergy other than removing the allergen and seeing what happens is that right? What age can skin tests start to happen when can you actually start testing for allergies?
Kaya Thorpe 37:02
So you can test for an allergy. Different trusts have different guidelines on when they might start doing the testing. Here, personal experience and experience of if the, they generally try to avoid doing skin pricks before two months, unless it is is quite desperate. in need. They will try and wait till later. But what should happen if a parent believes that baby has an allergy is that dairy should be removed from diet for a two week period. However that needs to be done. And then there should be a reintroduction. If on reintroduction, their baby shows a return to the original symptoms, which might not be as severe because they've not got as much in their system, that diet should be referred into a dietitian and paediatric lead allergy specialist service. Particularly for you know the human milk providing dyad there should be a dietitian referral done because obviously they've cut it from their diet, you can then skin prick test when you hit that level of support. And those tests can be reliable they might not be they only show an IGE reaction. So they won't show you a non IGE which is then where it gets more challenging and where you need that skilled support because it comes down to history and food diaries and things like that, and it can be really difficult. We also do see some babies throw random, positive to skim pricks even though there's never been an issue I'll I'll give a personal example here. My daughter Charlotte is on the allergy pathway. And obviously she is coming up five and following a recent anaphylaxis we went back in for skin prick testing. And she showed positive for wheat allergy. She's been eating wheat all her life, she's never had a reaction to it. We've never seen an issue, we don't have an issue with it. And on discussion with her consultant. No, we have not cut wheat from her diet because we don't think it was the right result. Because they can still be a little bit unreliable, they can then do blood tests. On top of that, and I have seen some trustee do prefer straight to go for the blood tests, but they don't do it till them. Babies are much older, which is then really difficult for a parent who's waiting. And it is just it's about finding that specialist support. Trying not one of the most heartbreaking things I see parents really go through while they are waiting and trying to get that formal diagnosis is I want to call it allergy eyes where you look at your baby and you view everything that they are doing as an allergic reaction and it becomes really hard to differentiate what's normal. And what's an allergy. You know, there's research come out of the UVA recently that shows that parents have allergy babies, particularly those who may have had an anaphylaxis I think it's seven times more likely to have post traumatic stress disorder. from the stress of dealing with an allergy, baby. So we have parents running on adrenaline on high stress, potentially dealing with a baby that's grumpy and not that settled. And waiting long periods of time allergy services are quite heavily backed up here. It's not unusual to have known families wait seven, eight months to see someone and that still might not give them the answer they need if their baby's not reacting IGE I've got one at the minute I'm supporting that's really not show nothing on the skin prick tests. And it's really just been supporting the mum with keeping a food diary and really monitoring what she's eating. To work out what the problem is. And that's, that's really difficult. And that's something that takes hours and hours of support and work from a parent that we don't have built into our NHS. And that's really sad for those babies.
Emma Pickett 41:00
Yeah, gosh. That's so stressful. Imagine seven months of dealing with a baby struggling, I just can't imagine how stuff tough that must be. These parents are the absolute legends. One of the things that I that Chris Van to look and talked about in his talk that I heard him give was he, he basically said, and I'm sure he'll never listen to this, it's not a big issue. But he essentially said that it's virtually impossible for a breastfed baby to have reaction to cow's milk protein, that when an adult parent is eating the milk, drinking milk eating dairy products, the proteins get broken down to you know, some tiny, tiny components, the amount of milk that would then enter as an intact cow protein into the breast milk is so teeny teeny, tiny. It's it doesn't make logical scientific sense to say that breastfed babies who are exclusively breastfed can have an allergy to cow's milk protein. And he said this last year in a roomful of breastfeeding supporters and I know that you have worked with families when elimination diet has absolutely made a difference. It cannot be just simply placebo. There's just no way. We're talking about physical symptoms that surely can't be just down to that. What sort of transformations have you seen elimination diets have for breastfed families? Tell me the story of one family where you feel it has definitely definitely without doubt made a difference. There must be cow milk protein getting into breast milk.
Kaya Thorpe 42:26
Yeah. So I do agree with you though. He's, it's it is very, very unlikely for fully breastfed baby to have an allergy, but it definitely does happen. I I'll give my own story with Charlotte because that's a really easy, obvious one. She was a very miserable baby from birth. very frequent feeder never really paid correctly. Didn't put on a lot of weight. I thought it was tongue tie. Had that divided very early, she was still a very miserable baby. She vomited constantly. She was covered in this horrendous rash. She actually lost all the skin on half of her face and that she'd been burned. From about day four onwards. She didn't poo for 11 days at one point, and then obviously lost weight when she did pee because it was so much of it. We introduced formula because stress was meaning that I was not able to pump and it was like we were handed Satan. She screamed repetitively. And I remember saying to midwives, could she be allergic to this? And they were going no, no, that's impossible. And it wasn't till I had an ibclc out who went? I think she might be allergic to it. I think you should try cutting it and we moved to cutting it. We minimised it in my diet. And this baby started to gain weight, she started to poo. She still wasn't, you know, great, but she was much better than she was a day to cut it completely. And ongoing to the GP I was told that I was wrong. A breastfed baby couldn't have a dairy allergy was impossible. I should just try some cream. And if I came back in two weeks, they'd give me some Gaviscon for the vomiting. I went back in two weeks, she was no better. I was still on a restricted diet. And I think I'd cut it all by that point. And he said again, I was wrong and I needed to eat dairy. So the following day, I was like, well, he must be I'm wrong. You know, and at this point, I'll hold my hands up. I was I was training to be a breastfeeding counsellor. I had access to a great skill. I spoke a lot to Catherine Stagg, and another ibclc Sean oldest from Pamela Mama's to talk to them. And I still believe that up and that I was wrong, so I ate pizza. Within four hours, she was back to demon and 24 hours later, we were admitted to a&e with nappies full of blood. We then did do a complete dairy restriction, and we did then end up removing Sawyer as well. And she was a different baby. At six months old. Her brother kissed her After drinking milk, he'd washed his face, he's brushed his teeth, and she came up in hives so severe that she required seven days of steroids to clear them. So, yes, dairy allergies are rare. But you can see they can be really, really impactful. Charlotte has deemed anaphylaxis to dairy and has had what we believe to be a dairy anaphylaxis. She is at the more extreme end of the scale. But there are still babies out there, you know, I see it a lot where they're not gaining weight, or they're unhappy babies. And I almost want to say that we just don't know enough for it to make sense. I've got two babies I work with at the minute both of whom require supplements. And those supplements are given in the form of hydrolyzed formula. And they're breastfed. And the moms will tell me that if they eat dairy, their baby is unhappy. But their baby tolerates the hydrolyzed milk, it makes no sense.
Emma Pickett 45:52
Tell me what is hydrolyzed formula for people who don't know what's going on with that protein?
Kaya Thorpe 45:57
So hydrolyzed formula is where it's broken, they break down the cow's milk to make it easier to digest. These are generally the formulas, they're the first port of call for prescribing, particularly in a baby that is formula fat. They don't taste too bad, they still contain some of the cow's milk protein, but they're easier to digest. There's more dairy still in that milk than there is in breast milk,
Emma Pickett 46:23
and more intact dairy protein and that milk because you can't remove it all when it's just hydrolyzed. So gosh, it is confusing, isn't it? And then tell me about the next step beyond that, if someone's been given a specialised formula, what's the next product beyond that?
Kaya Thorpe 46:36
So if I am working with a baby that hydrolyzed formula hasn't taken hasn't sort of really settled, the next step is then the amino acid based formulas. These are no cow's milk made from other things. There's a new Trojan and Neocate and an alpha amino, the other ones you see. And actually bizarrely different areas have different preferences, different preferences for what they choose to prescribe. Up here. We are, generally the amino acid based formula of choice by our paediatrician and then GPS is alpha amino, but actually with my Essex babies, I see a lot of Neocate.
Emma Pickett 47:13
And that's presumably partly about industry connection to who's ever buying in that area. I mean, we're not, you know, go back to the BMJ article and read about how industry connects to paediatricians and connects to managers and gets into these conversations. It's, we seem to have any evidence that one is any better than any other in terms of branding or anything. And, and you talked about soy allergy being connected sort of cow's milk, protein allergy, but there are not there are other reasons why we don't want to give soy milk under 12 months, can you tell us a little bit about that.
Kaya Thorpe 47:44
So under six months, we don't recommend having soya formula as a main drink. There's a little bit of evidence, it's not great for babies in terms of hormones and things like that. It's not something that would be recommended. It does say on the NHS guidelines, it should really only be used under medical guidance. However, it's the only non dairy containing formula that you can buy over the counter that isn't extortionate ly expensive. So I am seeing desperate parents move to that. Obviously, the other things around are things like goat's milk formula and things like that, again, if a baby is reacting to dairy, they will likely react to goat's milk because of the similarities in the proteins. So they are not recommended as a way of resolving a dairy allergy. It's it's really challenging, because there's so many different things on the market. And, you know, there's so many ways that formula companies want to get around their marketing laws and not being able to market something that they can really, you can really make a parent feel that if they're not buying the best formula for their baby, it's their fault. Yeah, they really get in from that perspective. But no, soy formula should not be prescribed for an allergy baby. It should be the hydrolyzed. And there's a really good guide on the infant milks run by first steps nutrition, which really breaks down all these formulas.
Emma Pickett 49:09
Yeah, I was just going to flag up first steps nutrition trust, I'll make sure I put the link in the show notes. They can discuss for you why we don't give soy formula, they'll discuss why cow's milk and goats formula are not necessarily that different. Yeah, that's a place to keep these discussions also about special formulas and what's going on in industry around these special formulas as well on their infant milks website.
Kaya Thorpe 49:30
They've got an amazing PDF, which breaks down all the specialised formulas. So parents can really see what they should go for because one of the amino acid base ones also contains soya and so from that perspective isn't great if your baby is reacting to swear.
Emma Pickett 49:47
Yeah. Okay. Thanks for flagging up that resource. I think that's really important people know about that group. So when a baby is very little and has an allergy, I think lots of parents think Well, well, that's it for the rest of my life. I will never be able to eat ice cream on the beach with this child. That's my life forever. But I'm alright and thinking that lots of babies will grow out of these allergies. I'm not saying this is necessarily your experience for Charlotte. But so child is reacting to dairy as an infant isn't necessarily going to be there forever. Tell us a little bit about that process of growing out of it. And what what's the milk ladder? How does that work? Tell me a little bit about what happens next.
Kaya Thorpe 50:22
So the evidence does show us that the vast majority of babies particularly with a milk allergy, will outgrow that milk allergy somewhere between nine months and one year. And you'll be able to slowly do a reintroduction, which is done by the form of the milk ladder. I would say I often see babies who are formula fed who do outgrow them earlier, because sometimes it's just down to the fact that it was just too much cow's milk their bodies, their little bodies couldn't process it, they've had a little bit more time to grow and develop and now they can. And equally I've seen breastfed babies just shoot up the ladder. So the milk ladder there's two out and about at the moment, but most trusts have now moved to the six step milk ladder. And it's a way of very slowly reintroducing an allergen into your baby and allowing them that time and allowing their body that time to kind of build it up and understand how to process it and not fight it. So with the milk ladder, I am generally seeing from paediatricians and dieticians, the recommendation for most babies now is to follow the six step. And it starts with things like biscuits, and then goes up into things like pancakes and cakes, and it's all comes down to the length of time that the milk has been processed for how long it's been cooked and things like that. So the top of the ladder, you're seeing milk and obviously, cheese and yoghurt. Chocolate actually parents need to remember is really high up that ladder. So starting very basics with biscuits with pancakes, then cupcakes and then moving into things like pizzas, potatoes that have been baked like shepherd's pie, and then moving slowly up. And it's a way of very slowly processing up. If you are weaning and on solid and you've been told to try the milk ladder, it should be done through the baby. If you are breastfeeding, and you've been told to use the milk ladder as a way of reintroducing to test, it's not that valid, because of the small volumes at the bottom ends of the ladder, it's unlikely to really show you something and when we're doing a reintroduction, we really need to mindful that we're talking about going in with that higher level of milk like yoghurt. But when we're milk laddering, we start at the bottom, the guidance is that you start depending on your baby, and depending on what the support you're given, usually it takes about a week to two weeks to run through each step of the milk ladder, you start with a very small volume. So with the biscuits, the malted milk is one that everyone's always heard of, you're often giving say, a quarter of a malted milk for a few days, then you give a half and then you give a whole one. As you move up, you keep the items within the baby's diet that they can eat. And you add the next item, it's really challenging to start with because a lot of the stuff at the bottom of the ladder is things like biscuits that you don't want to be giving your tiny baby a lot of. But obviously, as you progress, you can then move on from that there's a lot of recipes out there that parents can really start to try. It might be that a parent then chooses to pause the milk ladder if their baby has hit a cold or teething or a developmental leap to make sure they're sure is really important when you pause to always hold giving that standard volume still in and not going straight back. And you're just monitoring for symptoms. And that's where it's really challenging. And especially if you've had a baby, a parent who's had a baby with really significant issues. It's remembering that you're asking them to introduce something that can take them back to a really traumatic time. Yeah, actually, often at that point, what they need is some real TLC, you're saying to them, okay, so we say that your baby had an allergy. And to find out if your baby is still allergic and that they've they've grown out of it, I want you to feed it to them. That is something that's just really thrown out of oh, you can milk ladder Now isn't this great? But actually from a sort of a mental health perspective, it's it's a really dark place and this is often done at home. Only babies with the most severe allergies are generally admitted for for laddering. So you can see her parents really sort of struggle with that. Actually giving something and then not seeing a reaction, but they can really flip one of my one of my trusty babies. She's one of my favourite milk ladder fails because she failed on half a malted milk. She was very unwell, stopped it. Six weeks later, her mom caught her on her table, and she tried the Easter eggs. She demolished her entire easter egg with no issue flew through the Oh my goodness. So you can really see how it can be really illogical that that baby might six weeks ago couldn't tolerate a malted milk. But six weeks later, all of a sudden, holy easter egg was no problem. What is important to remember is that they might struggle from the perspective of the amount of actual sort of lactose in it. And it might make them not feel great. As a parent who has been dairy free, you should always stay a level behind and be really mindful, I always say, especially we've got a parent perhaps, who's ending their breastfeeding journey, and they're ready to move on and start eating everything can is to actually if you've not been eating dairy for a while, you've probably made yourself lactose intolerant, and to be really careful about how much you eat and how quickly because you can actually make yourself ill. And no one needs an ill parent.
Emma Pickett 55:48
Your gut is going whoa, what's this? Yeah, okay, so. So there's a there are a lot of mental health issues here, aren't they? When we're talking about supporting families with allergy, I think that's one of the big takeaways for this. For me, it's, it's a very stressful situation for a family to be in. It's super scary, especially when we live in a world where there's milk and allergens just everywhere. If somebody's listening to this, and they are worried that their baby does have an allergy, and they're struggling to get the right support. Do you have any kind of go twos in terms of resources and support groups we've mentioned first steps nutrition trust, for information about infant milks, any particular support groups that are online that you think are good?
Kaya Thorpe 56:27
There's a lot of peer to peer support groups, particularly on Facebook, they can be really useful, because they've often got, they know where to find the good biscuits, and allergy parent will always know where to find the good biscuits. And those support groups can be really great. But they can also lead parents into quite a dark hole. Because, again, as we talked about social media, are we following Oh, well, if your baby's reacting to 19 different things, and my baby cried at two o'clock in the morning, it must mean that my baby's reacting to 19 different things. So it's being mindful when you enter in equally, it's really important to talk to, like flight people, I always say, actually, for me, the best place to try and get support is your local breastfeeding support groups, and really get to them to speak to those parents about, you know, if there's another speak to the volunteers who are running them, some of the volunteers might have dealt with an allergy, well, they'll actually probably know someone in the group that has got that allergy baby, so that you can go and say, yeah, have a chat, because it's really valid that peer to peer support. There's not a lot of information out there on the web, I hold a resource on my website, which I will give you the link for to post at the end. But there's not masses, amounts out there. There's a few sort of small articles, but not a great deal if I'm honest. And and that's one of the really hard things. There is a couple of CMPA support groups on Facebook, they're very good for peer to peer support, but just reminding parents not to get drawn into that rabbit hole, as your only source of support.
Emma Pickett 58:01
Yeah, got to be sitting alongside a broader kind of support as well.
Kaya Thorpe 58:09
And you know, remembering that ibclcs will always generally a lot will man it will support families who are formula feeding as well. And talk to them. It might be that they need to go out and look for a more specialised ibclc some might not be comfortable in dealing with a formula fed allergy baby because it might not be somewhere that they sort of sit and we all have our cut off points. But I think it's really important to to give ourselves a shout out there so that we will support everyone if we can or will point them to someone who can.
Emma Pickett 58:41
Yeah, I'm not going to be doing at the same level of skill that you will when it comes to allergy, but I certainly support families however they feed their babies for sure. So tell us a little bit more about the the organisations you work with and the hats that you wear so you can see some people for free if they live in certain areas. Is that right? Tell us about? I don't want everyone to think who listens to this to go away. Let's go and find what tell us about what you can do and what you do locally.
Kaya Thorpe 59:04
So locally, I am the CEO of Lowe's often lonely breastfeeding support, which is a charity set up to cover the waves in the area of Norfolk and Suffolk. Lots of our amazing volunteers are ABM trained, we've got peer supporters breastfeed cancers and a team of three ibclcs. In that hat, I can see any family providing breast milk is having a difficulty. And with allergies, they're free. We offer free ibclc visits. I always say there is a team of three and for our CMPA babies it might not be me might be one of our other two amazing ibclcs Jenny and Lucy. But they've obviously got me in their pocket to go back to and sometimes I'll come in when it's more complex, if needed afterwards. I will under the remit of the charity, I do have a little bit of an exemption that if we have a baby who is formula fed who is struggling with allergies, I will see them. And we will always say that any baby, regardless of how they're fed is welcome at one of our breastfeeding support groups to come and have a chat and to find us and they can find us on Facebook. We've got the website most often when you're breastfeeding, and they can pop us an email or WhatsApp, things like that. And we can go from there. I then also work for the middle Club, which is based in Essex, even though I'm not there. They're an amazing team. Now they have funding for some areas of Essex, I can't tell you exactly what because as they will clarify my geography up here is bad enough, let alone my Essex geography. I believe it tends to be covering sort of the areas of basil and south end that we have some funding for. Those areas can access funding support, it can be partial funding, it can be fully funded. I don't actually get involved with that I let the the amazing milk hub lead Libby deal with with that side, I just do the work. Beyond that, unfortunately, from my perspective, it is a paid service. I obviously can't work for everyone for free. COVID did teach me that one.
Emma Pickett 1:01:04
So you have got you have got a private practice, although I don't know how you have time for private practice. But people can find you if they need to.
Kaya Thorpe 1:01:10
They can find me for my private practices under the milk hub. It's just not funded. For people in other areas, it's always worth dropping an email, I'm probably far too soft and shouldn't say it publicly. But I can't bear to see anyone struggle.
Emma Pickett 1:01:27
And you have children and needs and bills. And I've just seen your lovely cat who needs to be fed. No one should apologise for having to pay their bills, we can't all do everything for free. And if we might like to, and if someone really can't afford to pay for any private practice, hopefully there are others free support in their area as well. I mean, as you say, an organisation that literally for example, there will be electronic leaders who are more knowledgeable on allergy, though there will be other people around.
Kaya Thorpe 1:01:55
And often I can connect them if they haven't found their local breastfeeding group. Or we might be able to find an ibclc in their area who is more comfortable, if they want that face to face support, who might be more comfortable, sort of dealing with them. And you know, lots of ibclcs do have free clinics, free groups where families can drop in. And I'll often encourage that if we can find out where they are to get some support and then go from there.
Emma Pickett 1:02:21
So much need out there. We definitely need more training and support. I mean, if someone's listening to this, and they're a health professional, what would you say to them about how can they improve their level of knowledge? What can they possibly do? Are there any courses around infant allergy, you'd recommend anything?
Kaya Thorpe 1:02:37
There's not a lot at them in it. advertise myself will always get involved with delivering allergy training as an ibclc. Obviously, that is something I like to be paid for. There's not masters around there. There's a lot of reading, obviously, that that Chris France piece is really a powerful reading. And it really couldn't get into the mindset for a healthcare practitioner. I would always say to a healthcare practitioner when they are doing education, look at who's behind it, when they're doing that look at who's funding it. Because sometimes these companies are sneaky. And they won't outwardly say You know, we won't have a study day that is funded by someone that's really obvious. And that it would you would immediately go oh, that's that's for me that funded. It will be hidden in the depths and families will be unawares
Emma Pickett 1:03:30
fancy name, lovely little association of organisation of foundation of whatever it is, and it'll be a different name. And, ya know, everyone's got the ability to do a bit of you know, cyber stalking and find out what's really going on. It's, it's a slightly scary world, but people like you make it easier for families, for sure. Thank you for all your hard work. In this guy. I can can hear how passionate you are and helping families despite all your responsibilities and all the things that you're dealing with at home as well. If someone's listening to this, and they're having a rubbish day, and they're really struggling, they're on that waiting list to talk to the special team hospital. What message would you give to that parent who's listening to this and having a really, really hard time?
Kaya Thorpe 1:04:11
To reach out for support. And it might not necessarily be that at this minute as you're listening, you need a skilled support. It might be you need your mom, or you need your husband, you need someone who understands to give you a cuddle. I always think it's really good place to start having a cuddle it might be you know, you need your best friend to complain to. So often as parents we just barrel on, don't we? We can't stop. We don't think about ourselves and I think it's really important when you're dealing with a baby that's really quite difficult and actually with analogy is on well, to say it to verbalise that I'm not okay. To someone who can tell you that it's that's okay. It's okay that you're not okay. I don't know what to do. And I think that's a really valid answer for a lot of us working in foot feeding is that it's not to feel like we can solve it. It's to feel like we can support to find the resolution. do reach out, friends and family. First, for that support, get yourself to a place where you can then go and you can speak a lot of art, we're seeing a lot of movement towards having a good volume of perinatal mental health support within soil health as to services, reaching out into them, remembering to look after yourself, as silly as it sounds, everything like that. And if you do need it, find that sort of specialised support if you are, you know, breastfeeding or giving human milk in any way, shape, or form, find your local support group, you can then move on. If you can't find your local support group, you can't get to them. Because getting out of the house seems really hard. Give one of the helplines a ring, I mean, I'm sure that they're linked on your Facebook and your pages Emma, but you know, give one of the helplines a ring and talk to some of the amazing volunteers at the end of the phone. If you need to, and you want to reach out, find an ibclc sit with them and make sure that you've unpicked everything, and that you're on the right pathway for you. And there's not something it's really hard to sometimes see the wood from the trees. And just know that as an adult, if you're dealing with an allergy, and you've uncovered everything, that you're really doing an amazing job. And it's really hard. And it's okay to find it really hard. And it's okay not to be enjoying life, it's okay to be angry. Because you really won't have a piece of cheese, you know, it's just been Christmas, and you're missing out on your favourite treats. And you don't want to eat the vegan alternative and verbalise those feelings to somebody and get support. So that even if nothing can be done to speed up the actual medical side, to make sure that you're in the best possible place to dealing with it, and know that it won't be like this forever. And hopefully, something will change and life will be easier. And there should be light at the end of the tunnel.
Emma Pickett 1:07:01
Yeah, thank you very much for that Kaya. That's that's really appreciate you. I don't think we can underestimate how hard and the elimination diet is. I think people just think, oh, yeah, what's the problem? You're just reading labels. But food is joy for a lot of people. Food gives us joy, and if something really matters to us, and you know, it's really sad to be experiencing elimination diet. So I think that's really important that you highlighted that. Thank you so much for your time today. I'm really grateful. We'll put all your details in the show notes. And yeah, thank you again for your time today.
Kaya Thorpe 1:07:29
Thank you for having me.
Emma Pickett 1:07:34
Thank you for joining me today. You can find me on Instagram at Emma Pickett IBCLC and on Twitter @MakesMilk. It would be lovely if you subscribed because that helps other people to know I exist. And leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast. This podcast is produced by the lovely Emily Crosby Media.
Emma Pickett 1:08:07
One final thing, I have a discount code for my podcast listeners for my last two books, the one on supporting breastfeeding past the first six months and beyond and the one on supporting weaning or the transition from breastfeeding. If you go to the UK Jessica Kingsley press website which is uk.jkp.com and put in the code MMPE10. That's MM for makes milk P for Pickett E for Emma one zero, you'll get a 10% discount on checkout. Thank you