[Dysphagia] thickening breast milk

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

not a problem :) and you too!!

>>> "Beecher, Robert" <RBeecher@chw.org> 07/09/04 03:58PM >>>
Sorry, Kate!  Have a good weekend!

Bob

Robert Beecher, M.S., CCC-SLP
Senior Speech/Language Pathologist
Masters Family Speech and Hearing Center
Children's Hospital of Wisconsin
Milwaukee, WI


-----Original Message-----
From:     dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]  On Behalf Of Kate Farabaugh
Sent:    Friday, July 09, 2004 4:51 PM
To:    sorriso@adelphia.net; dysphagia@b9.com; Beecher, Robert; MICHAEL@email.chop.edu; pressmah@sjhmc.org; epwest@sympatico.ca; eripley@yahoo.com
Subject:    RE: [Dysphagia] thickening breast milk

Hi Bob
Actually I didn't make that statement, Hilda Pressman did! And I would contend that no, breast flow is not consistently slower especially if mom is engorged or baby is a voracious sucker :)...
Thanks for the response though and chance to clarify!
Kate

>>> "Beecher, Robert" <RBeecher@chw.org> 07/09/04 03:46PM >>>
Kate,
I'm not certain that statement is true consistently.  I think it depends on the nipple shape, size and texture for both breast and bottle.  Some human nipples may have more openings plus the letdown can affect flow as well.  The infant can control the flow of the milk from the human nipple, better than with the manufactured nipple, which I think is one of the most important factors.

Robert Beecher, M.S., CCC-SLP
Senior Speech/Language Pathologist
Masters Family Speech and Hearing Center
Children's Hospital of Wisconsin
Milwaukee, WI


-----Original Message-----
From:     dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]  On Behalf Of Pressman, Hilda
Sent:    Friday, July 09, 2004 1:46 PM
To:    'Kate Farabaugh'; sorriso@adelphia.net; dysphagia@b9.com; MICHAEL@email.chop.edu; epwest@sympatico.ca; eripley@yahoo.com
Subject:    RE: [Dysphagia] thickening breast milk

We also need to remember that milk flows slower from the breast than from
the bottle.  

-----Original Message-----
From: Kate Farabaugh [mailto:Kate.Farabaugh@BannerHealth.com]
Sent: Thursday, July 08, 2004 12:44 PM
To: sorriso@adelphia.net; dysphagia@b9.com; MICHAEL@email.chop.edu;
epwest@sympatico.ca; eripley@yahoo.com
Subject: RE: [Dysphagia] thickening breast milk


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
Exclusive Distributor:
www.interactivetherapy.com 
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