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Incorrect information from dietician

Posted By Giraffe14

"Incorrect information from dietician"

About: Tameside and Glossop Integrated Care NHS Foundation Trust / Children's healthy nutrition

(as a parent/guardian),

Attended a cows milk free weaning class this morning. At Hyde flowery field childrens centre. The dieticians information was outdated and somewhat incorrect. Do they review and update themselves with changes to guidelines and imaps? They frequently referred to cows milk protein allergy as an intolerance and stated that unless the reaction was severe with swellings and hives it was only an intolerance. This is not true and I'm quite sure they need to be retrained on ige and non ige reactions.

Both my children have non-ige delayed reactions to cows milk protein and they are officially diagnosed under allergy specialists as cows milk protein allergic. Not intolerant. They made off the cuff comments about may contains being OK again unless the baby had an allergy that presented in swelling or hives. This is incorrect and could put babies in harms way if parents then go on to feed their child may contain products. Babies who only display delayed non ige mediated reactions can and do react to may contains and cross contamination.

Their information around challenging with milk products was very vague and they not once referred to the milk ladder which again I feel is quite negligent. Thank you for taking the time to read my comments. I hope this goes some way to ensuring that community dieticians are given updated information or themselves take the opportunity to refresh their information.  

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Responses

Response from Tameside and Glossop Integrated Care NHS Foundation Trust 6 years ago
Tameside and Glossop Integrated Care NHS Foundation Trust

Submitted on 31/01/2018 at 12:32
Published on Care Opinion at 15:09

Good afternoon, thank you for your posting. We are sorry to hear of the experience you describe at the Cow’s Milk Free Weaning Class which is provided by the Trust’s Community Paediatric Dieticians.

Please be assured these comments has been shared with the team in order for them to address and take action to review the information that is being provided to parents and guardians. We are keen that all information provided to patients is as accurate as possible and your feedback is appreciated.

Your feedback has been shared with the management team and once any feedback has been received, we will provide an update to this posting.

Response from Gemma Smith, Head of Patient Experience, Tameside and Glossop Integrated Care NHS Foundation Trust 6 years ago
Gemma Smith
Head of Patient Experience,
Tameside and Glossop Integrated Care NHS Foundation Trust

Submitted on 26/02/2018 at 09:57
Published on Care Opinion at 11:39

picture of Gemma Smith

I am really sorry to hear that the group session did not meet your needs on this occasion. My team always aim to provide quality and personalised advice to parents and carers and the group sessions aim to provide an opportunity to meet other families with similar experiences.

Here at Tameside and Glossop ICFT we have undertaken a detailed review of the service offered to our children with cow’s milk protein allergy and the milk free weaning sessions have been established as part of this review. We are committed to learning how we can improve and would like to highlight below the actions that we have taken following your feedback.

Confusing use of terminology “intolerance v’s allergy”

The terms IgE and non-IgE are now increasingly used by dietitians; however we have found that other professionals, as well as parents and carers more commonly use the terms "allergy and intolerance". Because this session is designed to be easily accessible to all we had adopted the continued use of “intolerance and allergy”.

HowevImage titleer having considered your feedback, going forward we will amend our presentation slides to incorporate the use of IgE and non-IgE classifications.

Lack of advice around milk challenging and milk ladder

The session which you attended is specifically designed to educate on milk free weaning for infants of approximately 5-6mths old. A later group session (or individual appointment if required) is offered once the infant reaches around 9-12 months of age, to discuss the milk ladder. In infants with a history of anaphylaxis or severe symptoms direction would be given directly by a specialist.

Image title

Going forward, in order to avoid any confusion we will ensure that parents and carers are informed at the beginning of the session that further advice regarding milk challenging is offered in subsequent sessions. I have also designed a Session Outline Leaflet which will provide clear details on session content.

Trialling “may contain products”

The Food Standards Agency states that ‘It’s not a legal requirement to say on the label that a food might accidently contain small amounts of an allergen, but many manufacturers label their products in this way to warn their customers of this risk. For this reason, it is not necessary for all individuals to avoid ‘may contain’ products (as this may lead to an unnecessarily restricted diet), however, for those who have had severe symptoms or acute onset of symptoms, we would advise avoiding the products.

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Going forward, we will allocate more time in the session to discuss this area in greater detail.

Up to date training of delivery staff

Infant feeding is an area which continuously develops and The Paediatric Dietitians who deliver our infant feeding support group currently work to the Greater Manchester Medicine Management Group Guidelines 'Prescribing infant formula for cow's milk protein allergy in primary care' (May 2016). The guidelines continue to evolve and are due to be reviewed in May 2018. You can be assured that any recommendations will be incorporated into our ongoing staff training programme.

I hope that the details above provide reassurance that we listen, learn and act here at Tameside and Glossop ICFT. We value patient feedback and I would like to thank you for taking the time to share your experience.

If you would like further updates regarding the improvements made please feel free to contact me on the details below or alternatively you can contact our Head of Patient Experience Gemma Smith: gemma.smith@tgh.nhs.uk

Kind Regards

Rachel Lawson

Lead Paediatric Dietitian

email: rachel.lawson@tgh.nhs.uk

tel: 0161 366 2377 or 2376

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