Navigating Milk Allergies in Babies
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Meg: Welcome back, Moms and Dads to Sense by Meg Faure. I am Meg Faure. I’m your host here, and every week I join you to unpack some of the more tricky aspects of parenting. And sometimes we look at [00:01:00] things like discipline in toddlers, which is always a bit thorny. And sometimes we chat to moms who have got challenges themselves, and through exploring their challenges, we get to cover some of the ground that you want to have a look at.
Meg: Sometimes we have experts who join us and some of my favorite podcasts over the last year have been with Kath Megaw, Kath is a pediatric dietician and I always say she’s my partner in crime in everything that has to do with baby feeding. And that’s because she just knows so much more than I do and then actually than most people do.
Meg: She’s, I think if I had to express what Kath is, she’s a curious mind. She makes it her business to go and find out the absolute latest to solve the little problems or the big problems that her little ones have. And so she’s always at the forefront of the research in terms of infant feeding and just like adult diet is a thorny issue often and very polarized and moves in every different direction.
Meg: Infant feedings even more so and so Kath is a voice of reason in a [00:02:00] wilderness of conflicting information. So Kath, I’m always delighted to have you join us. So welcome here today. So Kath a little bit just about your background just for those who haven’t come across you before, which I’m sure is very few people. But just to cover it off you did your original dietetics degree in South Africa and then went to the Johns Hopkins University in the US to do your pediatric dietetics.
Meg: Is that right?
Kath: That’s right. Yeah. I managed to do a two year fellowship there, which was really exciting and was able to specialize in pediatric dietetics. It is a specialization. So I really felt that in order to give the best for the patients I really believe specialization is one way to do that, and had the privilege of doing that.
Kath: So, have basically been in pediatric dietetics since probably about over 20 years and journey together with my children who probably [00:03:00] taught me more than I learned anywhere in university.
Meg: Yeah. They, took your science and made it an art, I’m sure. Kath, I mean, you, you have many different fields of interest. I know that you work in the neonatal ICUs, making sure that our little preemies thrive. You also do work with moms as they start to wean their babies. In your private practice, you’re involved in keto diets for little ones with epilepsy.
Meg: And then another deep field of interest for yours because I know that it comes across your table often is actually allergies and allergic children. And you and I and Dr. Sarah Karabus wrote a book called Allergy Sense and Moms, a lot of what we’re gonna talk about here today can be found in the book Allergy Sense.
Meg: So if you have an allergic little one that is a book that you do want to go and have a look at. So Kath, that is what we are going to be looking at today. We’re gonna be looking at allergies. Allergies, obviously is just the most vast subject. So today we’re going super narrow and we’re going to be looking at milk allergies, specifically in [00:04:00] babies.
Meg: And so let’s kick right off and start by defining what a milk allergy is. I mean, a lot of people get confused and confused lactose intolerance with milk allergies. So can you just debunk a little bit of that and talk about milk allergies and then potentially touch on the difference between that in lactose intolerance.
Kath: A hundred percent. So I think it’s important to remember that if we term something an allergy, it’s normally an immune reaction. So your body’s immune system, which is there to fight viruses and bacteria and foreign substances, actually attacks a food protein, and that then is a food allergy. So it needs to be a protein in order to be defined as an allergy.
Kath: And so if you have cow’s milk, protein allergy, then your body immune system is basically attacking the protein that comes across in cow’s milk. If your child has lactose intolerance, which is very rare, primary lactose intolerance is very, very rare, and [00:05:00] it’s quite a severe condition. It often lands children up in hospital.
Kath: They aren’t able to break down the sugar that’s found in breast milk, in abundance, and then in a lot of cow’s milk formulas as well as any other mammal milk. So if your child is lactose intolerance, goats milk will be a problem. Caramel milk will be a problem. So it’s not just related to cow’s milk.
Kath: And so lactose is the sugar found milk, and it can be an intolerance. Your baby can’t break it down. Cow’s milk protein will be an allergy where your baby’s immune system reacts and has a reaction to that allergy. And in cow’s milk protein allergy, the type of reactions we normally see are much more gut related.
Kath: So it can be anything like vomiting or excessive diarrhea can be blood in the stools because. Immune system actually tries to fight to the degree where it can actually hurt the gut if the child has a severe cow’s milk protein allergy.[00:06:00]
Meg: Very interesting now I mean, allergies have become the flavor of the month in the last few years. Everybody has an allergy to something or at least an intolerance, but often an allergy. And of course, it’s not always true. I mean, let’s just have a look at, first of all, how prevalent is cows milk, protein or milk allergy?
Meg: Should we, should we say milk in general or milk allergy?
Kath: Yeah, so I think in your, it’s so cow’s milk protein allergy in babies is the most common allergy that we see in babies. And so 2 to 5% of babies can have some form, because that’s also where it gets a bit complicated because you’ve got two immune pathways that your baby’s body can react. The most common one is actually the, what we call the non IgEs.
Kath: So it’s the one that you wouldn’t pick up in a blood test. And for years we would say to moms, no, your baby’s not allergic. ’cause we don’t see it in the blood test. And now we know that it’s ACT Science has shown that [00:07:00] studies have shown us that it is a cow’s milk protein allergy, but it’s a different mechanism, which we don’t right now, have a sufficient blood test to show.
Kath: So it’s more based on the clinical symptoms and those babies often have quite a severe reaction to cow’s milk protein. But the good news, if it’s non IgE, in other words we can’t pick it up in the blood test, is that they do tend to outgrow it before a year, and that’s quite promising. If a child has a cow’s milk protein allergy that is picked up in a blood test and we do see those, they often last a lot longer and can last up to eight to 10 years of age even. So, that, and then they often are accompanied with other allergies, maybe wheat allergies but those will all be blood test related or the skin prick where you put a little bit the allergen on the skin and the skin has a reaction to that.
Kath: That if it is the common one that we see, which is the non [00:08:00] iG one. You can’t pick it up in the blood test or on the skin test, but it’s very real and it causes a lot of stress and and can hurt the baby’s gut really badly.
Meg: So let’s talk about I, I mean, let’s, let’s, let’s break this into two camps. We’ve got moms who are formula feeding and moms who are breastfeeding. So for our formula feeding moms, this would obviously happen if they are offering a cow’s milk based formula. Can you talk a little bit about that?
Kath: Correct. So to add further to complication, we have different cow’s milk protein. We’ve got whey based cow’s milk protein and casein based cow’s milk protein are the two dominant ones. There are a whole lot of others, but those are the two main ones that we look at. And so we have formulas that have got both in them, but we’ve also got formulas now that have just whey based protein and just casein based protein.
Kath: And often babies who have some reaction [00:09:00] to cow’s milk protein, we’ll be able to tolerate a whey based protein formula. And so we often will try that first before we cut out cow’s milk formula altogether. If the baby has a reaction to that as well, then the baby would need to be on either a formula where the cow’s milk protein has been broken down to such a degree that the body doesn’t recognize it anymore as cow’s milk protein.
Kath: So I always liken it. If you think of those old fashioned trains with the different train carts. If you have the whole train, that would be your complete protein, and the body reacts because it can see it coming a mile away. But if you break it down into just maybe say three of those carriages then the body might be a bit confused and might not react to that.
Kath: So we’ve got a formula that has that. And then if that doesn’t work, we can take out the individual carriages. And give that to the baby. And then the body generally never [00:10:00] reacts to that because it doesn’t, it doesn’t link it together as Cosmo protein. So we get the amino acid based and the peptide based formula.
Kath: So cow’s milk protein formulas are the most common and like I say, they can be distinguished between either being casein, being a combination, or being just whey based. And whey based are sometimes more tolerated in our cow’s milk babies because they’re more likely to be allergic to they casein.
Meg: Very interesting. Now, of course, that just sounded like a huge amount of swapping formula and trying one thing after the next. And of course that is what we see with our babies is that very often we have a little one who’s on formula. And at about two to three weeks old becomes a little bit more fussy because all babies do that ’cause they’re neurologically immature.
Meg: And by six weeks they might be crying quite a bit because that’s the peak of crying and mommy immediately thinks her baby is maybe so-called allergic to the formula and then starts the formula hopping. And that really is a horrible [00:11:00] space to be in ’cause you actually don’t know what’s working and what isn’t working.
Meg: So if we have a mom who’s listening whose little one has become very niggly at that time, and she starts to think about cow’s milk protein allergy, how should she be approaching it? I mean, is it a case of she just needs to see a professional or is there some advice you can give.
Kath: No, definitely, I think there’s definitely some things that moms can do, so I think it’s, firstly, if the baby is just becoming fractions, niggly maybe like just struggling with winds and just not a very comfortable baby. Then what you can do and that there’s no blood in the stools. The stools look still okay. The baby’s still having normal stools regularly and so no sign of constipation or anything like that ’cause a formula fed baby we really would like to see a stool pass at least daily, maybe at the most second day comfortably.
Kath: So if that is not happening, then obviously there’s a concern that there’s a bigger problem, but if your baby is still passing stools, but [00:12:00] just becoming more and more niggly as they are just growing into that next week of age, I would suggest going onto a whey based formula so I wouldn’t just change formulas. So often moms will change formulas ’cause they heard their French child is very comfortable on this cow’s milk formula.
Kath: And that’s where formula hopping becomes very stressful and really it’s not great for the baby either. So I would suggest if you are on a general formula, a good formula. Then go to a weight-based formula and there are quite a few now available in the different groups of formulas. And if your baby is still not comfortable on there, then you could go onto what we call a hydrolyzed formula, and that’s where there are then peptides if you get into that space so it is quite helpful to speak to a healthcare professional and just to understand, the journey on that path. So if you have changed her whey based formula and your baby is still not happy, [00:13:00] then I would suggest speaking to someone who’s got expertise in this area. So they don’t also take you on down a whole rabbit hole.
Kath: And then you would then need to possibly be on one of those more specialized formulas. If however your baby is got blood in the stools. Or just really showing or projectile vomiting when they have their feed, because that’s also a sign a sign of cow’s milk protein allergy.
Kath: Then the protocol internationally is to go immediately to a hydrolyzed formula, and so then you could try it, but it would be good to have advice and do that under guidance. In severe cases, we will move the baby onto an amino acid based formula immediately, but that the formulas do get more expensive as they become more specialized. And that’s why I do suggest doing it under the advice of someone who knows what they’re doing because then you don’t waste unnecessary money paying for the formula when that baby may be needed a [00:14:00] specific type of other formula.
Meg: Yeah. And I’m sure a lot of our moms are thinking, oh, I need Kath in my pocket. So Kath, they can get hold of you on Neutripaeds on the website, right?
Kath: Yeah, it’s.
Meg: Okay. So Neutro feeds is where you wanna get hold of Kath. So Kath, now we come to our breastfeeding moms , I breastfeed my little ones at that age, and they were niggly times.
Meg: And particularly with my third little one who actually really, really can’t tolerate any dairy at all. And she still can’t at this age.. I don’t know that she’s, I’ve never called it an allergy. Definitely in intolerance. She gets terrible gut issues, but when she was little, it was like that as well.
Meg: And of course I was breastfeeding, so there was sugar in the milk because the lactose in the milk, and so she was reacting to that. Now we get other moms who would be listening to this and wondering, okay, so is. Is my baby reacting to my milk because of the lactose, because we know that there’s sugar in the milk?
Meg: Or is it possible that my baby is reacting with an allergy to either my milk, breast milk, or to the cow’s milk protein that I’ve been eating in my [00:15:00] diet? So do we see this? I mean, is it possible to a, have an have an allergy? ’cause we’re talking about allergies today to breast milk and to the things that moms ingest through the breast milk.
Kath: So, yeah, maybe I can just speak for a minute just about the lactose and the breast milk. So, lactose is there for a very important reason because it [00:16:00] actually grows the healthy bacteria in the baby’s gut, but however, the one catch is when babies are born, they’re not born with enough of the lact. They’re actually born with no lactase enzyme to break down the lactose.
Kath: But with the presence of lactose in the gut, the body starts producing the lactase enzyme. But it can take a while. And while the body’s learning that it needs X amount of lactase enzyme, there’s all this lactose going in, and some of it’s not digested and for some babies that can cause a lot of gas, a lot of wind, and they can come across as a bit lactose intolerant, but they don’t lack the enzyme they just don’t have enough of it yet. So what I normally suggest for the moms with young babies, before three months of age is to just the way you can manage the lactoses in your breast milk. It’s just managing the amount of sugary foods and very refined starchy foods that you eat and also just not overdoing on the fruit because anything with a form of sugar, [00:17:00] glucose can increase the amount of lactose in your breast milk. So like I say, you’ll never eradicate lactose from the breast milk, which we don’t want to do, but you can maybe just lower the bar. So that the lactose enzyme can catch up with the amount of lactose you’re producing.
Kath: So it’s very sad for me when moms stop breastfeeding because of lactose intolerance, but they need to actually just give their babies a chance to actually get used to it. So that’s, that’s the lactose, the milk sugar. If a baby is reacting like a cow’s milk protein allergic baby, so maybe blood in the stools or maybe just very fractious and very upset it would be very advised and it’s very good protocol to cut out of the mom’s diet or cow’s milk protein.
Kath: Because that would mean that no cosmic protein molecules will go through the breast milk to her baby. And so then her baby’s got no cow’s milk protein to react to, and that normally sorts it out for the majority of [00:18:00] babies with cow’s milk protein allergy is for the mom to keep breastfeeding and to just remove all dairy and all forms on dairy, so that includes yogurts, ice cream, cheese, chocolates, and milk in your tea and coffee.
Kath: And that would then not be part of her diets anymore. And the babies normally do adjust and are actually quite fine in severe cases. And these are very, very minor. So the stats at the moment are saying point 0.5% of children with cow’s milk protein allergies. So not of all children, just of that 2 to 5% will react to the mom’s protein. So her breast milk protein, so her breast milk makes its own protein. Her body makes its own protein for the breast milk. And there’s that very minute, minor percent that will react to it. And that’s not nice because then you have to stop breastfeeding. And it’s always very sad for my heart when that happens.
Kath: [00:19:00] But you know, I have had cases like that. Generally those babies really only settle when we put them on what we call an amino acid based formula, which is the most expensive formula. It’s like liquid gold, and you really do spend a fortune paying for it, but it’s worth it. If that is the only way you can settle your baby.
Kath: So those are, those are extreme cases, but what’s very exciting and why most babies will tolerate mom’s breast milk, even when you remove cow’s milk protein is that her breast milk protein is hydrolyzed. So it’s broken down, it’s small, it’s like a little two or three little carriages as opposed to a whole train.
Kath: And that’s why they often will do fine. And the majority. So 99.05% will do absolutely fine on that.
Meg: Very interesting. So that’s super interesting for me, Kath, because you know, when I had my first born and you and I had our first born at around about the same time, there were these very, [00:20:00] very restrictive diets that moms who were breastfeeding were put on. I mean, we were told no cabbage, no onion, no green vegetables, no dairy, no eggs, no fish, it was just ridiculous. But at the end of the day, there was pretty much nothing left for us to eat. Because there was this crazy thought that allergies came through what we had given our babies and our milk and could make them niggly. It was just, it was all flawed science. So we then kind of went in the opposite direction, understanding that actually highly restrictive diets during breastfeeding are not a good idea. And we went through a patch where we did say to moms and probably still do say to moms, eat everything that is healthy in your diet. And I think you would agree with that.
Meg: So anything that’s healthy, don’t cut anything out of your diet when you’re breastfeeding. You know, go for it. Eat absolutely everything, obviously, unless you’re allergic to it yourself. So, so that is now the wisdom, of course. Now, but what I am hearing you say is that if you have got a baby who is very niggly and is not settling, and you are worried about allergies or intolerances, step number one is to [00:21:00] remove very sugary foods and highly processed carbohydrates from your diet. And maybe do that for five days and see what that does. ’cause that could deal with that lactose overload.
Kath: Great.
Meg: And then step number two, if that really isn’t working, cut out dairy of all forms and see whether or not that works for five days.
Meg: Would you say that that would Hmm, go
Kath: Yeah, you would do the dairy for two weeks because it takes the baby’s body and your body about 7 – 14 days to clear out.
Meg: Okay.
Kath: So the dairy, but the lactose you a hundred percent right, within that first week, you should notice a difference because your, your milk is kind of made on demand. So it’s, it’ll make a difference quite quickly and you will be able to see if you have a more comfortable baby.
Kath: So I like that first step. Do the sugary foods and then second step, do the dairy. But please don’t limit dairy. Trying to prevent an issue with your baby because as you’ve said Meg, is that you really need to include all the [00:22:00] allergens because that will actually be protective for your baby.
Kath: And there is a point where if I’m journey in with the mom who’s had to remove cow’s milk protein from her diet before we introduce cow’s milk protein to the baby in the weaning phase, we actually will introduce it back into mom’s diet so that the baby will start learning to tolerate the cow’s milk protein through her breast milk because it’s a little, and then we know, okay, we good to go let’s start with baby and cow’s milk protein.
Meg: Super interesting. Kath so that actually is a brilliant segue into exactly what I was going to ask you next. So let’s say we have a baby who has a confirmed cow’s milk protein allergy. And now the mom’s ready to start weaning. What is that process? First of all, any other foods she should be thinking about?
Meg: And then second of all, how does she introduce cow’s milk, into that baby’s diet? Or even, do we need cow’s milk in our diet?
Kath: Hmm. So I think just one thing to add in light of what you’re asking is [00:23:00] that sometimes we will require mom to cut out soya as well because 50% of children with cow’s milk protein allergy are likely to have some, soya allergy as well. That’s a very hard ask for moms I’ve noticed. So cutting out dairy is not too difficult, but cutting out soya requires extensive label reading and it’s quite stressful.
Kath: So I only do it if a baby doesn’t settle after having the cow’s milk protein removed and the baby’s better. Hundred percent, then we might do a soya trial. So I’m just saying that because, some healthcare professionals will do both at the same time because of the percentage risk. But I do find it’s very difficult for moms to live a soya free life, actually more than a cow’s milk protein free life.
Meg: So I’m interested in that. What, what, what is she looking for in labels when she’s looking for Soya? Is it always gonna be soya or is it, is it phrased and hidden and as different
Kath: No. So because Soya is a known energy it has to have, so, [00:24:00] but it might be a soya isolate or it’s a soya filler, like whenever they want to fortify food and, and get the protein up in food, especially the bread. They’ll add soya because it’s a very cheap way of increasing the protein of any food source. So, it just requires, like I say, a lot of label reading in a lot of your spices they’re soya, so soya like isolate cause it prevents spices from clumping together. So, make sushi not as tasty because you’re kind of soya sauce that, you know. So it, it really isn’t, it’s really difficult. It’s more difficult than we think it’s and it does require label reading much more extensively.
Meg: mm. Mm
Kath: um, yeah. So that is, that is just. Something, and I’ll only do it if it, if it’s really, really deemed necessary. But there is that higher percent, and we do have to be aware of it. And that’s why in the past, we would successfully manage children. Well, we thought we would successfully manage managing children on a [00:25:00] Soya formula.
Kath: We are bit reluctant to do that because of the high risk and, and then creating an issue around that as well. However, a Soya formula is very affordable and so I do find myself in cases where, you know, the cost of these specialized formulas are just too much for the family, and we will definitely do a Soya formula trial and hope that the baby can actually cope on that and there is that 50% chance.
Kath: So that’s also something just to, to keep in mind.
Meg: Okay, excellent. So now mum’s going off milk and taking a little one onto solids, which happens anywhere from 17 weeks to 24 weeks from from four to six months. First of all, I guess a very important question. Should we be delaying the introduction of solids if we have a confirmed cow’s milk protein allergy or any allergy really, is that, that’s identified before 17 weeks?
Kath: So definitely not. So those are the children we actually really want to get going with solid introduction and those [00:26:00] children there’s some new research going on at the moment, which I think is coming out to be quite conclusive that we should actually be in starting them off with the allergen foods.
Kath: Opposed to taking too much time to get going on all the veggies and that. So do one or two veggies and then get going with the egg and the nut butters and things like that.
Meg: But not the actual milk because now you’re, you’ve got pro. Okay, so you’re not looking for them. Correct. So just to clarify, you’re not putting them onto the, the allergen they’re allergic to, you’re putting them onto the other protein, protein allergic foods. Yeah.
Kath: yeah, so you’re gonna then put them onto all the other allergens that they could potentially be allergic to in order to see. Because they’ve already shown you, they’ve got a hyperactive immune system that is just targeting proteins. So you want to get those proteins in to let the, the big, the big thing with early allergen introduction, the whole idea behind it is that if you make something known to the body and you make something appear to be safe and common, the body’s [00:27:00] not going to attack it.
Kath: So it’s not like a foreign protein, and that’s why you wanna build it slowly. So you do do it early on and you will then introduce your, all your Allergens and do them until you’re happy that the baby can tolerate them. The kas milk protein allergen though, like I say, if the child is on breast milk, we will first introduce it via mom’s breast milk, and if the child is on formula, we will do a.
Kath: Step down formula. So we would want the baby to tolerate if they’re on, for example, an amino acid based formula, which is our top end one where there’s no association with cosmic protein, we would first step them down to a hydrolyzed one where the, there’s a few cars together, but not a lot of carriages.
Kath: And if they’re on that one and that, then we would want to step them onto our WHE based protein formula. So that would be the progression. If the child is then [00:28:00] tolerate the weight-based protein formula, we can then start to introduce very slowly the cow milk protein. The baby’s actual food diet. So that would be direct introduction.
Kath: But there’s a milk ladder in which we do that, and it’s not just giving the child milk in their porridge now, or just giving them a spoo whole cup of yogurts. We can, I can discuss the milk cloud if you want me to, but it’s a, basically, it’s, yeah, it’s just really helpful to understand the, the basic, to keep it very simple.
Kath: The way the milk later works is we do it with something that is baked in the oven first. So we introduce Cosmo protein in like a baked. Or in a baked dish where the oven has reached 180 degrees, because that breaks down the cosmic protein extensively. So again, you’re just given a little bit, but in a very safe way to the baby.
Kath: And then we’ll go [00:29:00] from there to stove top temperature up to. Point of a hundred degrees. And then from there we’ll start to go with things like a yogurt or like a cottage cheese. And then last we’ll be moving them onto milk. So that takes time. And it normally, if, if you look at the stats internationally, and if I look at my practice, which is aligned with that, we do that between nine months to 12 months of age for babies who have the.
Kath: The clinical cosmo protein allergy, but not diagnosed in the, in the blood test. So at that point, we do like to establish which one we looking at, because that will determine our journey to reintroduction.
Meg: very interesting, very interesting. And when you’re talking about that ladder, you’re obviously talking about specifically on, on dairy there. But there are also other alternative forms of yogurt, let’s take for example, or milk that could be used. So everything and my head is going from a yogurt with fer in it as an example all the way through to [00:30:00] something like an almond milk yogurt.
Meg: And let’s take for example, so one has absolutely no dairy in it, one is dairy, but has been fermented with kefir. So can you give us an idea? Are, is there any differences do those play any role in these, with these babies’ diets?
Kath: Absolutely. So I think in the beginning, because yougurt we talk about yogurt cause it is such a go to food and it is so lovely incorporated it’d, we lucky now days that you can, if the baby tolerates soya, you can do a soya based yogurt. If the baby tolerates coconut, you can do a coconut based yogurt. You can get depending where you are in the world. I mean, I’m so jealous internationally. You can delicious almond I know in the uk delicious almond based yogurts and so yummy cashew nut yogurts.
Meg: Yeah. I made a curry last night with a, with an almond yogurt. It was lovely. Yeah. Yeah.
Kath: Yeah, so it really, really is nice. We do get locally in South Africa, we do get some that do come at a huge cost. So the, probably the most affordable are your coconuts and your soya based yogurts. [00:31:00] So those you can definitely include, and I would encourage moms to do that, just to add variety to the diets.
Kath: And the other thing it does is it exposes the child to the texture from yogurt. Because what we do find with allergy kids, is that they can tend to be a bit restricted in what they’re exposed to. So I do like to encourage moms to even do a dairy free cheese, which is coconut based cheese. And that allows them to, when they get to the handhold stage, to hold the cheese to experience a bit of cream cheese that’s non-dairy mixed into food for that creamy taste so you expose them to those similar textures. So when you do reintroduce the potential allergen, they’re used to what that allergen would taste like and feel like in their mouth, which is really important for texture acceptance.
Meg: Okay. Very interesting. And just quickly, I mentioned keyfir yogurts. I mean, is that just the same as any old other yogurt?
Kath: Yeah. So if a child has a cow’s milk protein allergy, [00:32:00] it wouldn’t be one of the early introductions, but it would, yogurt and kefir yogurts are great. So the more fermented the yogurt is and the higher the probiotic counts in the yogurt is, we know that the gut is the better chance of accepting it.
Kath: But if the child is still very allergic to the cow’s milk protein, it’s not really going to make a difference
Meg: Okay. Alright. Super interesting. Kath, we have covered off a very thorny issue today and in a lot of depth, so this probably wouldn’t have been an episode for absolutely everyone, but it is an episode, an essential episode for everyone who does have an allergic child to one of the milks. So thank you for joining us and as always, for your incredible wisdom.
Meg: And moms, if you are wanting to get hold of Kath, Kath, can you just give them an idea of how they can get hold of you?
Kath: The best is you can go to my website, so it’s just www.nutripaeds.co.za and there you can just have a link, which they can send an email or request or ask a question on there. That’s the easiest.
Meg: And then just for those of [00:33:00] you who in America who don’t spell peds like we do in the UK and South Africa, the spelling of this is N U T R I P A E D S, Nutripaeds. And that is the best way to get hold of Kath and of course do go and get her book Allergy Sense as well for those of you who have got allergic babies.
Meg: So Kath, thank you very much. I really do appreciate your time as always.
Meg: Goodbye.
Kath: Thanks Meg.
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