[Dysphagia] thickening breast milk

[epwest at sympatico.ca (Eva West)]

 I would agree that there is much less reflux with breastfeeding.
Unfortunately, it does still occur in some babies no matter what the milk or
formula. I often find that by the time babe is determined to have a problem
needing medical attention, mom is so frustrated and exhausted that she has
switched to formula.

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Shaker, Catherine S.
Sent: July 8, 2004 6:11 AM
To: 'Eva West'; 'sorriso@adelphia.net'; 'Dysphagia listserv (E-mail)'
Subject: RE: [Dysphagia] thickening breast milk

Some babies who breast and bottle feed expressed breast milk may indeed have
swallowing problems, and these are the situations I think Paula is asking
about. I have not had experience with MDs asking to thicken EBM for GER, in
fact clinically I see less GER in breastfed babies.
 
-----Original Message-----
From: Eva West [mailto:epwest@sympatico.ca]
Sent: Wednesday, July 07, 2004 7:38 PM
To: sorriso@adelphia.net; 'Dysphagia listserv (E-mail)'
Subject: RE: [Dysphagia] thickening breast milk


I do not specialize in pediatrics, but I do see a number of infants
throughout the year.  The usual reason that I see for pediatricians ordering
thickened milk for infants is gastro-esophageal reflux (normal in smaller
amounts - "spitting up") that is so excessive that it is decreasing
available milk to the infant and affecting weight gain.  It apparently
doesn't stop the reflux, but reduces the amount that is refluxed enough
allow better weight gain. The usual thickener I see being used for formula
is infant rice cereal, but occasionally a pre-thickened formula such as
Enfalac AR.  
Because of enzymes in breast milk, rice cereal won't thicken it, and so I
have heard of Simply Thick (Xanthan Gum) being used.  I have personally
never had a client using it though, so I can't comment.  
It should be noted that thickening milk does not work for all babies with
excessive reflux.  It should also be noted that the babies that I have seen
on these thickeners generally are NOT having any sort of swallowing
difficulty, and they are NOT aspirating or having any respiratory problems
associated with the reflux, so what happens if it enters the lungs isn't
really an issue.  The issue is nutritional - they just spit back too many
calories! Eva West RD

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of sorriso@adelphia.net
Sent: July 7, 2004 7:46 PM
To: dysphagia@b9.com
Subject: [Dysphagia] thickening breast milk

There was a post today on the ASHA Division 13 listserv asking about how to
thicken breast milk.  Given the debates on this list about thickening
liquids in other populations I was wondering what the consensus is about
breast milk.  So far no one has offered a solution that works and no one has
questioned why it's needed in the first place.

I'm hoping this starts a lively conversation!

Linda A. Zanchi, MA CCC-SLP


_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia


_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia


Privileged/Confidential information may be contained in this message.  The
information contained in this message is intended only for the use of the
recipient(s) named above and their co-workers who are working on the same
matter.

The recipient of this information is prohibited from disclosing the
information to any other party unless this disclosure has been authorized in
advance.

If you are not intended recipient of this message or any agent responsible
for delivery of the message to the intended recipient, you are hereby
notified that any disclosure, copying, distribution or action taken in
reliance on the contents of this message is strictly prohibited.  You should
immediately destroy this message and kindly notify the sender by reply
E-Mail.

Please advise immediately if you or your employer does not consent to
Internet E-Mail for messages of this kind.  Opinions, conclusions and other
information in this message that do not relate to the official business of
the firm shall be understood as neither given nor endorsed by it.


_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia