netFormulary NHS Crawley and NHS Horsham and Mid Sussex CCG NHS
Formulary  
 Search
 Formulary Chapter 25: A2 - Borderline (infant feeds,gluten free) - Full Chapter
Notes:
Click to view Infant Feed Formulary Infant Feeding Guidelines and Appropriate Prescribing of Specialist Infant Formula Milk

See GP guide - Oral Nutritional Supplements for guidance on prescribing oral nutritional supplements and food first approach.
Further useful resources can be found here

See Infant Formulae Prescribing in Cow's Milk Protein Allergy (CMPA) 

Cows Milk allergy advice from SASH dietitians

Guide to home challenge for food allergies SASH
 Details...
A2.03.01  Expand sub section  Specialised formulas: Infant and child
 note 

Cow’s Milk Protein Allergy (CMPA) is an adverse reaction to the protein in cow’s milk. Treatment is avoidance of cow’s milk and therefore, in many cases, a specialist infant formula is required for children aged up to 2 years.

To prevent wastage, the need for formula should be reviewed regularly using recent correspondence from Paediatrician / Dietitian (all children with CMPA should be reviewed by a paediatric dietitian to ensure nutritional adequacy).

Soya milk is a 3rd line option, due to glucose damage to teeth and uncertain effect of phytoestrogens.

These guidelines for GPs have been developed in consultation with our local Paediatric Dieticians. They provide an overview of:

The key things to consider when reviewing ongoing prescribing.
Formulae commonly used in cows’ milk protein allergy to help GPs make prescribing decisions on products and quantities.

A2.05  Expand sub section  Feed additives
A2.05.01  Expand sub section  Special additives for conditions of intolerance
A2.06.01  Expand sub section  Gluten-free foods
 note 

Following the national consultation on the availability of gluten-free foods on NHS prescription, the government has decided to restrict prescribing to bread and mixes only. The majority of consultation responses were in favour of this.

This means that Gluten-free foods from the following categories can no longer be prescribed on NHS prescription (or supplied via Gluten-Free Community Pharmacy LCS); biscuits, cereals, cooking aids, grains/flours and pasta.

They were added to the NHS blacklist on 4th Dec 2018.

In response to this and to align our list of products with appropriate prescribing quantities to CCGs in our area, we have approved a list of gluten-free foods for ongoing prescribing/supply via community pharmacy.

Gluten-free foods on prescription or supply via community pharmacy scheme will be limited to 8 units per patient per month from a list of fresh bread/rolls, long life bread and bread mixes as per the following list

A2.06.01  Expand sub section  Bread to top
A2.06.01  Expand sub section  Loaves
A2.06.01  Expand sub section  Baguettes, buns and rolls
A2.06.01  Expand sub section  Speciality breads
A2.06.01  Expand sub section  Cookies and biscuits
A2.06.01  Expand sub section  Crackers, crispbreads, and breadsticks to top
A2.06.01  Expand sub section  Flour mixes and xanthan gu
A2.06.01  Expand sub section  Flour mixes
A2.06.01  Expand sub section  Xanthan gum
A2.06.01  Expand sub section  Pasta
A2.06.01  Expand sub section  Pizza bases to top
A2.06.01.01  Expand sub section  Gluten and wheat-free foods
A2.06.02  Expand sub section  Low-protein foods
A2.06.02  Expand sub section  Bread
A2.06.02  Expand sub section  Cake, biscuits, and snacks
A2.06.02  Expand sub section  Cereals to top
A2.06.02  Expand sub section  Desserts
A2.06.02  Expand sub section  Flour mixes and egg substitutes
A2.06.02  Expand sub section  Pasta
A2.06.02  Expand sub section  Pizza bases
A2.06.02  Expand sub section  Savoury meals and mixes to top
A2.06.02  Expand sub section  Spreads
A2.07  Expand sub section  Nutritional supplements for metabolic diseases
A2.07  Expand sub section  Glutaric aciduria (type 1)
A2.07  Expand sub section  Glucogen storage disease
A2.07  Expand sub section  Homocystinuria or hypermethioninaemia to top
A2.07  Expand sub section  Hyperlysinamia
A2.07  Expand sub section  sovaleric acidaemia
A2.07  Expand sub section  Maple syrup urine disease
A2.07  Expand sub section  Methylmalonic or propionic acidaemia
A2.07  Expand sub section  Other inborn errors of metabolism to top
A2.07  Expand sub section  Phenylketonuria
A2.07  Expand sub section  Tyrosinaemia
A2.07  Expand sub section  Urea cycle disorders (other than arginase deficiency)
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Black

Comment : Not to be routinely commissioned (prescribed) in any care setting (primary or secondary care). This may be due to a lack of good clinical evidence, cost effectiveness, concerns over safety or due to the availability of more suitable alternatives. As such, drugs classified as Black should be considered as non-formulary.   

Red

Initiation : Specialist only
Repeat Prescribing : Specialist
Monitoring : Specialist
Comment : Prescribing must be in line with any specific treatment criteria outlined. In exceptional circumstances a GP may be asked to prescribe the specialist must provide adequate information and support.   

Amber

Initiation : Specialist only
Repeat Prescribing : Primary care OR specialist
Monitoring : Primary care OR specialist
Comment : Monitoring according to Effective Shared Care Agreement (ESCA) for stabilised patients only. GP agreement should be requested by specialist and confirmed/declined by GP on a patient-by-patient basis.   

Blue

Initiation/Recommendation : Specialist only
Repeat Prescribing : Primary care
Monitoring : Primary care
Comment : Should be initiated or recommended by a specialist. Monitoring of either medicine or disease does not require specialist skills or equipment   

Green

Initiation : Primary care or specialist
Repeat Prescribing : Primary care
Monitoring : Primary care
Comment : Suitable for non specialist initiation   

OTC

Patients should be advised to purchase if approriate.  

netFormulary