Tuesday, 25 November 2014

No more Mr NICE guy.

I'm actually fuming. Really spitting angry. Because of THIS.


I joke that I've been "riding the reflux roller coaster" for many, many years. But actually, it's no joke at all. Not even a tiny bit amusing. Because when you can be accused of something as utterly ridiculous as not feeding your baby appropriately/sufficiently because an arrogant health professional has never heard of reflux occurring in children without considerable disabilities after the age of twelve months you begin to lose your cool. And that was after many years of (relative) restraint, anxiety, despair, sleepless nights, screaming babies and nearly losing the plot all together.

Most babies DO outgrow their reflux. It isn't always a long-term debilitating problem. Neither is it a "disease". It is a symptom - usually of an immature sphincter, perhaps due to a developmental disorder and is often present in those with other underlying health conditions, but increasingly it is due to the gut responding inappropriately to food proteins (most commonly cow's milk) and causing inflammation.

The gut is basically a hosepipe. inflammation anywhere will, can and DOES have an impact anywhere along it's length. So kids with constipation will commonly have reflux and people with a slow emptying stomach will have reflux due to backwards pressure too. It's really not rocket science - yet STILL top consultants cling to the outdated notion that reflux is a Disease in its own right.

And babies with bowel inflammation will most likely have significant acid reflux. 

WHY?

Because they are on a liquid diet, because they spend a long time lying down and because their gut is immature (and the sphincter muscle sealing the stomach may not be quite tight enough) meaning they regurgitate more and also swallow more air, which needs to come up. (How many reflux mums will tell you that the entire feed will come back until the wind, trapped at the bottom *finally* comes up? probably almost all.)  Babies are also at higher risk of gut allergies too - at least in the short term due to a permeable gut which is designed to allow maternal antibodies through and offer extra immunity. (Which is why the WHO recommend delaying weaning until 6 months of age.)

There is increasing evidence that gut bacteria play a role in the infant gut, immunity and gastrointestinal disorders. Babies have a suppressed immune system at birth which gives a narrow window for the colonisation of their gut with healthy, protective bacteria. But in the West too many babies are given antibiotics early, or born by caesarean section, or are formula fed and all these factors do have play a contributory role.

We also have this ridiculous notion in the West that babies should be allowed to cry. Babies cry to communicate with their mothers - you won't come across babies sleeping in separate rooms, "crying it out" or suffering from "colic" in the indigenous populations of the Third World. And this bizarre acceptance of infant distress is a hang-up from bygone times - yet STILL mothers have to try and explain to their (usually male) doctors that something is not right, that their baby is suffering - struggling to have some recognition of their (very valid) opinion.

So this paragraph made me particularly furious:-
"A lot of this is about the relationship between the baby and the mother and the mother's reaction to anything unpleasant or abnormal happening to the baby. "This guideline will empower GPs to reassure mothers there is nothing is wrong and they will get better on their own."
We should not have mothers sent away being told a persistently unhappy child is acceptable, a figment of our imaginations or in any way appropriate to ignore. 

I've been fighting, campaigning and persistently spreading the word about reflux for 17 years now. We all suffer here - possibly partially due to a connective disorder, certainly due to gut inflammation - but I spent months of Hell with ALL four of my children trying to obtain appropriate support. Even when lack of answers led to the finger being pointed at ME I refused to stay quiet, because I have reflux. It hurts! My Dad has suffered all his life - nearly died of aspiration pneumonia when younger, we have a family history as long as your arm, and whilst I would have LOVED those years of sleepless nights to have been a figment of my imagination, my husband would testify to the contrary.

So WHY, after years of progress are NICE seeking to turn the clock back?


https://www.flickr.com/photos/dad/

I do think we have lost our way a bit. GPs began to play "catch up" and realise that infant Gaviscon only helps a tiny percentage of babies with reflux. It is a thickener too, creating a "raft" over the stomach contents and whilst this can be useful in some babies, it slows down gut motility and often causes constipation - which makes reflux worse! Even when this is less obvious it can slow gastric emptying sufficiently to make things worse.

(Some!) Doctors also began to realise that early weaning is probably not a good idea. Babies with reflux may sometimes be low in weight and solids fill them up but are less calorie dense. They slow down the gut too as their take longer to digest so yes, a risk of constipation and making reflux worse! The infant gut is permeable for the first six months and foreign food proteins can often get through and cause a local allergic response.

NICE Guidelines for diagnosing and treating food allergy INCLUDING non IgE responses was published in Feb 2011 and whilst there is still a VERY long way to go more anymore doctors are recognising that food proteins are causing the (very real) conditions such as FPIES, Proctocolitis, IBD and Eosinophilic Disease. Top paediatric allergists like Adam Fox have explained how food proteins such as Cows' Milk can and do cause problems and the message was very, very slowly starting to get through......

So stronger medications were prescribed - acid blockers like Ranitidine and Proton Pump Inhibitors like Omeprazole which definitely help hugely in appropriate cases. And the pharmaceutical industry responded in full, omeprazole is now one of the top prescription drugs in the UK, across all age groups!

And now, it seems there is concern that too many infants - and children, are taking these drugs. 

Absolutely. 

I would not disagree with that at ALL. But apart from the tiny minority that maybe are over-prescribing, I assume doctors would correctly refer cases on to professionals best able to judge whether such drugs are necessary?

Surely the bigger issue here, is WHY so many infants and children are NEEDING these medications?

Even our consultant in London has said there is an "epidemic" of such cases.

DOES THAT NOT BOTHER ANYONE?

Apparently not, it's easier to blame mothers, after all what do we know about our own children?

But most of all, I'm furious that this slipped under the radar - the article is from AUGUST, when most mothers are in the middle of the summer holidays busy with families or away. The directive is here and the draft guidance here.I hope to goodness someone actually addresses the real issues here. 


  1. Infant reflux with additional food related concerns is on the rise, and reaching almost epidemic proportions.
  2. IgE food allergies are also on the rise. Approximately 30% of children in all primary school classes will have an allergy.
  3. Gut allergies (non IgE) allergies are under recorded and poorly understood. Recent research and progress is actually now being diluted to fit in with National opinion.
  4. Somehow, the way live, the way we produce and process our food is contributing to this exponential rise in both food allergies and gut inflammation which cause reflux and bowl disorders in our young people.
  5. Less than 1% of medical research funding in the UK goes on gastrointestinal topics, NONE on paediatric gastroenterology. Isn't it about time we recognised not only the importance of the gut, but it's role in our overall health?
  6. The way we view mothers, babies and families has to change. Because slapping down mothers who are worried about their babies is certainly not the way forward. Scapegoating them will NOT address the fundamental concerns in the West about our gastrointestinal health, reflux is not going to go away, and neither are bowel disorders relating to food allergy.


Have your say - sign the epetition to change outcomes for mothers and their babies with reflux.



Friday, 21 November 2014

Facebook Group Recipe Round-up




The members of our Facebook group are soon going to put me out of a job.... we've had some inspirational cooking with very few ingredients showcased on there this week.


Here a just a few of them!





Chicken Pop Corn Kebabs

  • Cooked chicken breast, cooked mashed sweet potato, dash of oil and a little water if needed. 
  • Bind all ingredients together in a bowl with maize meal (polenta). 
  • Season if allowed and then divide into balls and pop on a baking tray, keep checking and turning. (Not an exact science as to when done. Just check and check.)
  • Once crispy and firm take out. I bought cake pop sticks and put 3 on each (like a kebab). 
  • Eat hot and cold.



Gingerbread Reindeer

Using a slightly different recipe to mine - (from the Glutafin site) one member made her own gingerbread reindeer. It's really simple, you can read more here.


I love the glass cherries for the red noses!

Lollies - Coming Soon!!!

Last but not least, I take my hat off to the person who made lollies on sticks from sugar alone, and wrapped them to look like store bought lollies! A real treat. For children who can only eat homemade food, sometimes making something look less homemade is a treat. My Mum used to make most off my clothes when I was younger, and clothes with labels in generated a great deal of excitement!


Keep checking back/subscribe for more info on how to make these simple treats.

Monday, 10 November 2014

Please Vote for The Recipe Resource!


As many of you know, I've been trying to get The Recipe Resource a higher profile over the past year with much success.  Out of over 15 000 UK Blogs The Recipe Resource hovers around the #275 mark which is wonderful, we've hit #48 on eBuzzing in their Health category also. 
However, there is still a HUGE way to go! 

Once again I've entered the UKBlog Awards #UKBA15 and would love you to vote for me.

Please follow the link to vote for us - voting opens on Monday 10th November and ends on Monday 1st December. Every vote counts!

Friday, 7 November 2014

Gingerbread Reindeer

A lovely easy biscuit recipe from a friend that you can decorate to make reindeer! This was a wonderful tip I saw doing the rounds on Social Media last year.



This recipe is so easy, it's a blend of various recipes so things like xanthum gum may need tweaking and the amount of flour may need to be increased. This will make about 30 gingerbread men/reindeer.

Ingredients

• 140g pure sunflower spread
• 100g dark muscovado sugar
• 3 tbsp golden syrup
• 350g Doves gluten free plain flour
• 1 tsp gluten free bicarbonate of soda
• 1.5 tsp Xanthum gum
• 3 tsp ground ginger
• 1 tsp ground nutmeg
• 1 tsp ground cloves


Method

Heat oven to 200C/180C fan/gas 6. Line 2 baking sheets with baking parchment. Melt butter, sugar and syrup in a pan. Mix flour, soda, spices and xanthum gum in a bowl. Stir in the butter mix to make a stiff-ish dough.

Wait until cool enough to handle, then roll out dough to about 5mm thick. Stamp out gingerbread men, re-rolling and pressing the trimmings back together and rolling again. Lift onto baking sheets.

Bake for 10-12 mins until golden.

Cool 10 mins on the sheets, then lift onto cooling racks.

Decorate upside down as reindeer!

Tip: Remember that these will spread a little in the oven so keep a bit of a space between them.  
These keep for about a week in an airtight tin, dough should freeze if made in quantity.

Thursday, 30 October 2014

Hallowe'en!

On the off chance your children have yet to remind you, tomorrow is Hallowe'en! If they would like to learn more about the history of Hallowe'en, send them over to our sister Blog, The Diary of Dorothy Whiskers.

Here at The Recipe Resource we have been busy preparing some old favourites with a Hallowe'en twist, and inventing some new ones!



If your little ones are at nursery tomorrow, I posted a lunch box suggestion last year which popped up on Social Media.




You can adjust this to suit your child's diet, so use houmous/sweet potato puree/nut butter on the pumpkin and this could be a roll (just made pumpkin rolls with the Juvela Harvest White Mix here in silicone pumpkin moulds) or savoury cookies. Similarly alter the filling for the celery and se red pepper if strawberries are not tolerated, raisins instead of the olive.... be inventive!

Today I made the chocolate muffins from here which would not work so well for egg allergy sufferers as you are substituting 3 eggs. However, I have used cornbread with cocoa powder which always achieves excellent results. Then I popped them into Hallowe'en cupcake cases from ASDA and iced them with the Betty Crocker Chocolate Fudge icing which is, surprisingly free from most things! lastly the ASDA graveyard decoration kit was also free from all we were avoiding but would not suit everyone.

The Krispy Cakes are Little O's (but could have been any cereal) with melted safe chocolate and a little golden syrup mixed with them and left to set, with Haribo Mini Halloween Jellies on top.

There are plenty of Hallowe'en treats available for children with allergies, although most reach for Haribo, but with a bit of imagination and a few cutters, stamps and accessories you can achieve a great deal!

I've just finished decorating, and we're all set!






Friday, 24 October 2014

Mini Crumble Pots!

I'm rather pleased with this! Using the wonderful Clearspring Organic Puree pots, I have created mini Crumble Desserts for my two.




These little pots are individually sized, and unlike some of the "baby" versions we have relied on in the past they are not at all watery and make perfect desserts on their own, in baked goods or in a pudding.




Method
  • To make these I used the Apple and Blueberry purees as October is #AppleMonth . I scooped one teaspoon out of each pot (yum yum!) as without this the pot would become too full and bubble over in the oven.
  • I then sprinkled on a little of my crumble mixture, which I tend to keep a bag of in my freezer. (You could just as easily crumble a flapjack over the top instead.)
  • Bake in the oven at 180C for 5 minutes!
For the Crumble Mixture


Ingredients
  • 6 oz Dove's Farm flour 
  •  2 oz gluten free oats 
  • 2 oz sugar (soft brown for a warmer, nutty taste) 
  •  4 oz Pure sunflower.
They were a big success here today!

Wednesday, 22 October 2014

The Ultimate Cheat Sheet on Gluten Substitution

Disclaimer : These are just some of the ideas I have picked up over the years. I'm a parent, dragged kicking and screaming plunged into freefrom cooking and gradually finding my own way. I'm not a nutritionist, not a health professional, just a parent but one hoping to help others on my freefrom journey. 

Many Recipe Resource readers are "MEWS" free, which for those who don't know means "Milk, Egg, Wheat and Soy free". Increasingly however, children (more so than adults) with allergic gut disease are reacting at cell level to gluten - yet are NOT coeliac. I wrote here about the differences between Coeliac Disease and a Gut Allergy to Gluten. They are NOT the same thing. A person may indeed have gut allergies (non IgE responses rather than systemic whole body IgE reactions) AND Coeliac Disease but that is not because they have the same cause. What IS interesting however is that EGID is increasingly likely to have an autoimmune component.

For the purpose of this post, I'm focussing on ways of creating culinary perfection (or close to it!) WITHOUT gluten. Going gluten free is far more involved than removing wheat -but isn't as scary as it sounds.

SO how do you rework your diet to exclude Gluten? 

Here follows the Ultimate Cheat Sheet on going Gluten Free.

1. To exclude Gluten you need to know what it IS.
Wikipaedia states:-"Gluten (from Latin gluten, "glue") is a protein composite found in wheat and related grains, including barley and rye. Gluten gives elasticity to dough, helping it rise and keep its shape and often gives the final product a chewy texture."
And herein lies the problem.  Many grains contain gluten, and more are contaminated with it due to milling and production processes.

Image courtesy of Amy Myers Md

Gluten is potentially everywhere! You need to check, check, check and check again. Assume nothing.

2. Alternative names for Gluten.

Anything with "wheat" in the ingredients, however low on the list isn't remotely gluten free. Likewise beware of flour, malt (from barley unless otherwise specified), bulgur, semolina, spelt, frumento, durum (also spelled duram), kamut, graham, einkorn, farina, couscous, seitan, matzoh, matzah, matzo, and cake flour. Often marketed as a “wheat alternative,” none of these is even remotely gluten-free. More detail on an excellent site "Gluten Free for Dummies" here

There is excellent, fully comprehensive information on Coeliac UK on shopping gluten free, which symbols mean wheat/gluten free etc and how to avoid gluten.

Interesting fact:-
Wheat starch is actually wheat that’s had the gluten washed out. In some countries, a special type of wheat starch called Codex Alimentarius wheat starch is permitted on the gluten-free diet.
cracker stack image courtesy of thanunkorn at FreeDigitalPhotos.net

3. Shopping Gluten free

There are now many brands which cater for those eating gluten free and it is becoming increasingly easy to source gluten free products and product replacements. Companies like Udi's, DS Gluten Free, Newburn Bakehouse, Juvela, Genius and supermarket brands all stock an ever increasing range. However, if you are already on a restricted diet this may not be of much help. Our GP practice will prescribe gluten free products as my twins have a diagnosis based on biopsy. However 90% of products available for prescription have soya in which we have to avoid! Multiple food exclusions usually means you are baking yourself...

4. Baking gluten free

Many recipes allow for straight substitutions. For example I bake regular sponge cakes with Dove's Farm flour, and although it contains some Xanthan Gum I usually add another teaspoon. Xanthan Gum is a sticky binding agent and replaces the sticky binding role gluten plays in regular wheat flour.






If, however your child is allergic or intolerant to the ingredients in the blended flours you can create your own from tolerated alternatives. Use the following chart to replace wheat/rice with your choice of flour(s).



4. Binding Agents

If your cannot use Xanthan Gum there are some alternative options to replace the elasticity and air trapping gluten brings. The air trapping is especially important because without being able to hold the CO2 made by yeast or baking soda, baked goods can’t rise. Elasticity makes dough more malleable, holding it together so that it doesn’t turn into a crumbly mess after baking!

You have to following to choose from:-
  • Eggs (rarely an option for allergic children so I won't pursue this although do see my Tiana coconut flour recipes if you tolerate eggs.)

  • Gums -Xanthan gum is a polysaccharide from fermentation of sugars and used in many food products. It also works as an emulsifier. Guar Gum is similar, coming from the Guar Bean. Both work well in baking. If combined together they thicken and have an effect greater than twice the original effect!

  • Gelatin such as Agar. This is a vegetarian/vegan option made from seaweed. Not great for baking and definitely better for more brittle products.

  • Flax Seed Meal/Chia -When hydrated the oils in the flax create a nice viscous solution more similar in baking properties to a gum. The starch granules become hydrated in a viscous solution and the expansion of air cells facilitates gelatinization of the starch which is the binding effect.





5.  Thinking outside the box

Sometimes, you need to stop thinking of replacement and start thinking alternatives. Do you need a bread alternative or a pasta substitute? Going gluten free can in fact be quite liberating, although tricky for a child with the aded bonus of suspicion around food and reliance on familiarity.

We are so conditioned in the West to reaching for wheat based carbohydrate than it can take a while to educate the mind AND the palate, but there are many exciting alternatives out there.

Avoiding wheat - meal alternatives

Think rice cakes, corn cakes, rice balls and rice noodles for lunches.

Cornbread as a savoury loaf with chilli or sweetened to make a cake.

Savoury Pancakes with Buckwheat and filled with veg and pulse based mixtures.

Potato cakes, with lentil burgers and tomato sauce.

Lasagna using vegetables sliced to make the layers.

Think basic, natural and fresh, then build up from there. There are increasing numbers of Paleo dietary foods and these are grain free and naturally gluten free and generally healthy. We have become so reliant on wheat and other grains that our overly processed diet is dependent on them. Going gluten free can be tough at first, but you can get used to it. Ensure your child gets sufficient protein to fill them up though - fruit and veg are great but are not very satisfying.



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