Thursday 27 September 2018

Lemon Loaf Cake DF EF GF WF SF NF

This is my variation on a gingerbread loaf recipe in Pippa Kendrick's "Free From Food for Family and Friends".  It's a fabulous recipe, rises well and is so simple and quick to make.



Ingredients

  • 275g Gluten-free self-raising flour (I use Doves Farm)
  • 1tbsp Mixed Spice
  • 1tsp additional gluten-free baking powder
  • 200g soft light brown sugar
  • 100ml sunflower oil
  • 2 tbsp lemon juice 
  • 1tsp lemon flavouring
  • 170ml water

Method
  • Preheat the oven to 200C (400F) then lightly grease a large loaf tin and line with baking parchment.(Tip, I buy the ready formed loaf tin liners from Lakeland!)
  • Sift flour, baking powder and mixed spice into a large mixing bowl.
  • Pour over the lemon juice, sunflower oil and lemon flavouring plus 170ml water and mix until you have a smooth batter.
  • Tip the mixture into the prepared loaf tin, levelling the top with the back of a spoon.
  • Bake for 30-35 mins or until a skewer inserted into the middle comes out clean.
  • Leave to cool for ten minutes before transferring to a wire rack.  DO NOT CUT until full cool.

Freezes really well in slices ready for last minute treats, packed lunches and days out!



Thursday 19 April 2018

The Child First and Always?


Last night we waited for the ITV programme on Great Ormond Street with trepidation. So many families I know feel violated all over again by the articles over on The Bureau of Investigative Journalism which although ground breaking in many respects fall short of holding the Gastro department at GOSH to account.  They - and we - have had to endure years of poor care/no care/false accusations whilst being kept in the dark about what was really happening at the hospital. For some it's cathartic that some of the truth is coming out at last, but for many it's opening old wounds.

Our thoughts?
It was a good start. We thought the documentary was quite clear the disease exists, but is rare. It covered the accusations of over diagnosis and over treatment simplistically but fell short of making it clear how desperate many families are for help by the time they get to GOSH. More concerning was that it also came across on the programme that it was clear cut this had occurred and that this was founded on an agreed definition of Eosinophilic Gastrointestinal Disease - EGID.

Anyone who has any experience of EGID will tell you there is no such thing.

Sunday 15 April 2018

A Post Fact Era

- or how Great Ormond Street Hospital for Children managed to avoid the factual information of their damning Investigative Review in 2015 from going public whilst parents took the blame.

So today, you have probably read The Guardian article on over diagnosis and over treatment of EGID at Great Ormond Street Hospital over the past seven years. Having been in the middle of this for all of those seven years, I can assure you there is MUCH more to the story. There is more info here, sadly the Syrian situation meant the Guardian article was cut down. It's STILL not the whole story though. 

Warning: This is super long. The events at Great Ormond Street over the past few years have left many of my friends and I reeling, collateral damage as the Gastro department attempted to extricate themselves from a hugely damning - and damaging, had it been made public - investigation by the Royal College of Paediatrics and Child Health. What followed their investigation in 2015 should make you angry. Very angry. This hospital persistently campaigns for charitable funding over and above any other hospital in the UK. Many departments are centres of excellence, but not Gastro. The RCPCH identified considerable failings, but in an attempt to restore order the proverbial baby went out with the bath water. Good doctors were scapegoated along with parents and the biggest losers of all were the patients. 

Children.

Our Story
We first went to GOSH at the end of July 2010. With a very strong family history of reflux and associated gastro issues, also seemingly non-associated non-gastro issues, we were desperate for answers.  As per our story here http://thereciperesource.blogspot.co.uk/2014/02/why-i-set-up-recipe-resource-long.html we were making progress on the reflux but struggling with motility issues, distension and a host of other issues.

We initially saw our new consultant privately, following an NHS referral from our local hospital being moved to another Consultant. (Our local paediatrician was keen for us to see this particular doctor because she had several patients under him and felt he was most expert on allergic gut conditions and would aim for the most normal approach possible, unlike some consultants at GOSH who were renown for pulling all food and imposing formula only diets when EGID or similar was suspected.)

Our consultant was quite thorough but very quickly fitted both twins into the allergic gut camp during our discussion. 

The photo below of our son’s hugely distended abdomen concerned him considerably. He later said he was concerned this was symptomatic of Pseudo Obstruction but in actual fact it was more connected with the 12 sachets a day of Movicol he had been prescribed locally for some time - something I had been concerned about. Movicol is the same plastic that is in disposable nappies. All parents have no doubt seen what happens when a toddler in a nappy sits in water.... it's a great drug for those with hard stool, but if your gut can't move loose stool, it certainly isn't going to do a great job of moving large volumes of loose stool...



We were prescribed medication - cetirizine daily, sodium chromoglycate and maintained our high dose of PPI medication (acid production suppressant) and were booked for review. Unfortunately our son’s motility issues were no better so he was booked for a gastroscopy and colonoscopy. This was no knee jerk reaction. Our son was going 2-3 weeks without passing stool then blocking the toilet, and was in huge discomfort. We were told that significant eosinophils per hpf were found throughout his bowel, in addition to lymphoid hyperplasia and he was diagnosed with Eosinophilic Enterocolitis. 

There was discussion as to whether Lymphoid Hyperplasia is EGID “waxing” or “waning”, and I actually asked how he knew eosinophils were intrinsically bad - or whether they in fact be part of the repair process? I know of many families for whom LH became the sole reason for diagnosis, and later many more who were diagnosed on symptoms alone. I suspect the desire to reduce invasive testing was the paramount concern for our consultant, but however well intentioned this meant some were perhaps labelled without supporting evidence. This should however be weighed against the merits of trialling treatments to produce resolution as quickly and easily as possible though with minimal discomfort and maximum gain for the patient. For this reason we never queried his assertion that our daughter was also an EGID patient.

Over the next few years our children never really became symptom free, although treatment DID mean they were better managed, growing properly and thriving.  

This should not be understated. Gt Ormond Street is not a local hospital. It's usually a place of last resort, where children with chronic or seriously acute problems go when no one else can help. Families are often desperate - like us - and grateful for help. It's also a place of novel and slightly unusual treatments, doctors are at the cutting edge of paediatric medicine and are always trying to push boundaries to help children. We embraced the plan - and the early results it brought.

Thursday 15 March 2018

Going Dairy Free

A good friend's daughter is embarking on a medically advised dairy free diet for her son and my friend asked me for some substitution tips. It occurred to me that recent posts have focussed more on those on very restricted diets, and whilst that is our reality there are many out there catering for single excursion diets - which can be just as daunting and stressful at the outset!

I wrote some suggestions down and decided it would be a good idea to publish them on the Recipe Resource!

First of all, the usual disclaimer! Children have complex nutritional needs and dairy products fulfilling many essential requirements. The vast majority of children outgrow dairy allergy, and those who are dairy intolerant are usually only temporarily so. Whilst nothing can stop an adult imposing restrictions on their own diet, you must take advice before taking such steps in a child's diet. Calcium, Vitamin D and other minerals - plus essential fats and low sugar make cow's milk a perfect food and drink for most children. 



Getting Started
I have a "Basic Substitutions" page here with some information, but this article focusses on purely Dairy Free diets. 

First, try not to substitute all dairy with soya products. Soya is high in oestrogens, and also highly allergenic in itself. It's not uncommon to develop an allergy to soya protein, and you increase that risk in an allergic child by substituting wholesale with soya. That said, if you are allowed soya it should mean you can more easily achieve a balanced diet without dairy products, without some of the sugar that is put in all free from foods.

When you take out food proteins, you remove flavour, so manufacturers replace it with sugar…. a concern which I have written about before. Most free-from biscuits and cakes are full of cheap fillers and “non-foods” so I always bake myself wherever possible.

Monday 19 February 2018

Devonshire Apple Cake - #EF #DF #SF #WF #GF

Unbelievably, my twins turned twelve yesterday. TWELVE!!! Scarcely seems possible. And yet, in so many ways they are proving extremely mature and sensible beyond their years. 

Well, sometimes

Their birthdays are always a little bittersweet. Usually when the children reach a milestone, or celebrate a birthday we think back on their early years, and I invariably fish out an older photo (or two) to post on social media. How cute they were! Except with the twins. They were so, so unwell for weeks - months - that their early photos bring pain and sadness, and not a little anger. 

Despite a strong family history of reflux, despite suffering myself, my father also, despite knowing EXACTLY WHAT I WAS TALKING ABOUT when I took them to the GP at 3 weeks old, *nothing* was done for SIX MONTHS. Nothing. Just weekly weights, the odd blood test, the usual fobbing off - and the ward social worker visiting me to see "how she could help me" and "what I could change" to help feed them more/help them gain weight. Because of course, it had to be my fault - how could I be so naive to try and continue breastfeeding twins?!

But it stands to reason if you regurgitate every feed until it's time for the next one, you are not going to gain much weight. And if you are in awful discomfort from burning acid reflux which is so bad you develop a hoarse cry and torticolis, go rigid and display symptoms of Sandifer's that you may very well not want to feed. Because it HURTS. 

Eventually, we had to go private, and the twins were given medication. We had tried an elemental feed but it was so thin that until the inflammation had been reduced, and their reflux slightly improved it wasn't going to stay down. So I embarked on a strict maternal exclusion diet and breastfed them, on new medications until such time as they were well enough to take the formula as a top up - and guess what. They started gaining weight. 

It's really not rocket science.

And yet this is what happens all over the NHS. Twenty years after I dealt with this with my eldest son the NHS STILL blames parents - mothers - first, and thinks outside the box second. And using private healthcare brands you a diagnosis-seeking,  desperate-for-intervention type of parent. Not a good image at a time when 20% of ALL under 5s are referred to Social Services and MBP or FII referrals are sky high. But I would do it again in a heartbeat, and no baby should be left to suffer months on end like they did.

Anyway... this birthday was all about CAKE! Both twins wanted a unique cake, to fit with their current favourite flavours. K loves apples and apple muffins. My Mum has always made a Cranks Apple Cake, from her recipe book dating back almost 40 years. Wheat and Gluten free is easy, as is dairy free, but egg free - and she had no egg replacer - is more of a challenge. The result was so successful that I thought I must share - particularly since some of my readers have children who cannot tolerate egg replacer!



Saturday 20 January 2018

Spanish Almond Cake - contains EGGS

Whilst this won't suit anyone with an egg allergy, it's perfect for coeliacs, those allergic to wheat/gluten or avoiding flour. There are only THREE ingredients, it's *really* simple to make and absolutely delicious! It works as a single, deeper cake, or as a birthday/sandwich cake.

Gluten free, wheat free, dairy free, soya free, contains only sugar, almonds (ground) and eggs.



Ingredients

  • 200g caster sugar
  • 4 eggs
  • 200g ground almonds
Method
  • Beat the eggs and sugar together until pale and fluffy. This takes approx 5 mins in a mixer, much longer by hand.
  • Fold in the ground almonds
  • Transfer to either one 8" springform tin or two 6" sandwich tins
  • Bake at 180C (170C Fan) for 40 mins if in a single, larger tin or 25 mins if two smaller ones.
Allow to cool. The top may rise to form a "crust" which has a tendency to collapse after. Don't worry! It tastes moist and delicious inside! You can add raspberry jam as a filler, like in a Bakewell Tart, or cherries, or even chocolate. Dust with icing sugar and serve!
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