1 . How old is your baby?
System.String[]
2 . Does your baby vomit more than usual or outside of meal times?
System.String[]
3 . Does your baby suffer with reflux?
System.String[]
4 . Does your baby suffer from wind or bloating?
System.String[]
5 . Does your baby have diarrhoea?
System.String[]
6 . Does your child have constipation?
System.String[]
7 . Does your baby suffer from red, raised lumps skin (hives)?
System.String[]
8 . Does your baby suffer from dry, scaly, itchy skin (eczema)?
System.String[]
9 . Does your baby suffer from repeated sneezing, coughing or wheezing?
System.String[]
10 . Have you noticed any eye, lip or facial swelling after feeding your baby?
System.String[]
11 . When did you first notice the symptoms that you selected yes to above?
System.String[]
12 . Is your child restless whilst sleeping or inconsolable when awake and crying?
System.String[]
13 . Does your baby arch their back as a sign of discomfort?
System.String[]
14 . Does your baby refuse to be fed or struggle with weight gain?
System.String[]
15 . How is your baby being fed?
System.String[]
16 . If you started using formula milk did you notice the symptoms around the same time as this was introduced?
System.String[]
17 . Have you started weaning your baby onto solid foods
System.String[]
18 . If you have started weaning your baby, did you notice symptoms particularly around the same time you started introducing solids?
System.String[]
19 . Does the baby’s direct and/or non-direct family have any allergies or eczema/ asthma? (direct = mum, dad, brothers and sisters; indirect = grandparents, aunts, uncles, cousins).
System.String[]
Your answers can help you prepare for the appointment with your doctor. You can print this page and take the print out with you on your next appointment.