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[Dysphagia] Pediatric RD feedback



If the baby is healthy and not at risk with his calories Mom has to decide 
if she really wants to get him on the road to feeding by mouth.
She doesn 't have to give everything up all at once and shouldn't feel like 
her choices and concerns are 'wrong'.
She needs to be part of the problem solving and prioritizing the plan.  She 
needs to trust he is almost 3, he can handle more than a 1 yr old.

It is true that if you eat all through the nite you will be less likely to 
be 'hungry' during the day.
The word "normal" shouldn't be used.  I would rather say this is not a 
typical feeding pattern for a 3 year old.

Mom needs to decide what is important.  Is her sleep more important than his 
learning to eat during the day? ( Maybe so, if there are other children to 
care for, she hasIf  to work, etc. reasons why she just can't function if he 
doesn't sleep through the nite).
Then she has to realize that she may have to give up a little sleep for a 
little while but not forever.  A little sleep loss and a lot of gain.

Is his reflux really better during the day because he feeds all nite or has 
it just been getting better in general?  The presence of a g-tube in general 
can make reflux more apparent.  There are other aspects to improving reflux.

Will he loose weight by just cutting one feed at nite?  What is culturally 
typical for this family?

Is he only receiving formula through the g-tube or is he eating by mouth as 
well?
Find out what she is really afraid of and try to work "WITH" the RD.

Thanks for your question.  I am anxious to hear from others on this one. 
These tube feed babies are tough to make the progression.
The fact that he still has the colostomy and the g-tube also does affect the 
appetite, etc.

Good luck.

Lisa


----- Original Message ----- 
From: "Minnie Bray" <minniejor at yahoo.com>
To: <dysphagia at dysphagia.com>
Sent: Monday, September 13, 2010 1:08 PM
Subject: [Dysphagia] Pediatric RD feedback


2-yr-11-mo old with hirschsprung's disease, ostomy bag, reflux, g-tube, and
taking minimal amounts by mouth. He is gaining more weight than the RD and
pediatrician are comfortable with. Parent reported he is currently taking 31 
oz
of Pediasure/day and 7 oz of water/day. He takes a little less than half of
that amt through a night feeding. The RD talked to Mom about decreasing the
night feed since that isn't "normal". Mom is apprehensive about this because
she feels he sleeps better and has less reflux issues during the day by
spreading out a feeding through the night. The mom is also wanting to give 
him
a chance to be hungry during the day to possibly motivate him to take more 
by
mouth. Any thoughts?

Minnie Bray, M.S., CCC-SLP
Speech Language Pathologist



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----- Original Message ----- 
From: "Minnie Bray" <minniejor at yahoo.com>
To: <dysphagia at dysphagia.com>
Sent: Monday, September 13, 2010 1:08 PM
Subject: [Dysphagia] Pediatric RD feedback


2-yr-11-mo old with hirschsprung's disease, ostomy bag, reflux, g-tube, and
taking minimal amounts by mouth. He is gaining more weight than the RD and
pediatrician are comfortable with. Parent reported he is currently taking 31 
oz
of Pediasure/day and 7 oz of water/day. He takes a little less than half of
that amt through a night feeding. The RD talked to Mom about decreasing the
night feed since that isn't "normal". Mom is apprehensive about this because
she feels he sleeps better and has less reflux issues during the day by
spreading out a feeding through the night. The mom is also wanting to give 
him
a chance to be hungry during the day to possibly motivate him to take more 
by
mouth. Any thoughts?

Minnie Bray, M.S., CCC-SLP
Speech Language Pathologist



_______________________________________________
Dysphagia mail list: Normal and disordered swallowing information
Dysphagia at dysphagia.com
Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
Visit the new Dysphagia Web Forum: http://dysphagia.com/forum 




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