[Dysphagia] thickening breast milk

[Kate.Farabaugh at BannerHealth.com (Kate Farabaugh)]

I recommend going back and trying every nipple you can get a hold of while cervically auscultating AND trying babe at the breast in different positions etc. What does he do best with coordinating resp/swallow and pacing etc.
I recommend going back and thoroughly analyzing the video you have on this infant to sort the cause of his aspiration during this particular study to see what you need to do clinically to cause it not to happen, knowing that it may not happen again and that reflux may be an issue too? Again, what happened with the thickened stuff during the study that didn't happen (or vice versa) with the thin and treat or address that. If you used only barium during the study, consider that viscosity and weight of the barium in the results..... you can never thicken his formula enough to match thick barium but positioning may get you the result you need?
I would basically jump through hoops to keep this kiddo fed orally and to not have to thicken his breast milk b/c those are great goals.
Good luck and keep this case coming, it has been a great discussion!


Kate Farabaugh, MA, CCC-SLP
Pediatric Rehab Manager
NCMC/Banner Health System
970.350.6155
FAX 970.378.3858

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>>> "Staci Michael" <MICHAEL@email.chop.edu> 07/08/04 10:27AM >>>
Then what do you suggest for an infant/family in the situation I have described.  Given that the literature is implying no benefit of thickening, given that the swallow study reveals otherwise... do you recommend no longer oral feeds?  Seems a strong recommendation given the circumstances.

Again... given a family who wishes to continue to feed their baby breast milk orally and has been identified as an aspirator... WHAT can we use to thicken?

>>> "Irene Campbell-Taylor" <eripley@yahoo.com> 07/08/04 12:21PM >>>


Kate Farabaugh <Kate.Farabaugh@bannerhealth.com> wrote:
Unfortunately it is the concept of thickening ............ being used pervasively without proven benefit that concerns me the most. 

** Why only infants? Thickening is without proven benefit in anyone. See: Robbins et al. ASHA SID 13 Newsletter, Perspectives on swallowing and swallowing disorders, 11(2), 16-19, 2002.





Dr I Campbell-Taylor
Clinical Neuroscientist
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www.interactivetherapy.com 
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