Debbie, is no one asking 'why?"? Was this 4 month old born preterm? If yes,
how is the baby's feeding history possibly contributing to aspiration during
normal feeding? (With the "get more in faster" way many preterm infants
often are bottle-fed, it's a wonder more don't develop aspiration, feeding
aversions, etc.) If this baby was term, what is going on that a normal term
infant, who should be able to feed normally, is aspirating? And why is it
acceptable to bandaid a problem by using a thickener vs. really trying to
find out what is going on with this baby?

A SLP-IBCLC colleague once sent me a post from a professional SLP list,
similar to Lactnet, when the topic was thickeners, including Simply Thick.
Several issues came up, including: the lack of evidence on the benefits vs.
risks of use, concern that thickeners may lead to poor infant hydration
(since fluid intake is often less with their use), etc.

And what is meant by the word "allow"? How is it up to docs (who don't seem
to be even trying to discover cause) to "allow" or not this baby to BF? I
would wonder about positioning at breast, whether mom has a particularly
strong MER flow and/or "super" production, etc. and what interventions were
tried...

All the best to this mom and her baby -- what a worrisome situation for Mom
to deal with!

Karen Gromada




>
> A client of mine has a 4-month-old who was diagnosed with severe
> aspiration about six weeks ago.  After the feeding evaluation, the
> specialist ordered her to immediately discontinue feeding at the breast and
> instead had her pump her milk and feed it to him in the bottle using the gel
> form of Simply Thick.  To every four ounces of milk, she adds an ounce of
> Simply Thick, so each 4-ounce feeding is really five ounces by volume (but
> not calories), and his wonderful weight gain immediately dropped off as soon
> as she started feeding him using this method.
>
> He's also having terrible problems passing stools, having to strain
> and concentrate to pass the stool, even though he's getting basically
> 100% breastmilk and the Simply Thick.  The GI specialist is happy to
> prescribe a laxative to take on a daily basis, but she isn't comfortable
> with this option.
>
> She heard from a local naturopath that adding oil to the feedings
> can increase the calorie content of the feed and improve ease of stooling,
> but she is naturally quite cautious about following this suggestion; and
> then she's not sure what kind of oil, quantity, etc.  The doctors aren't
> offering any other options besides the prescription meds, and she's afraid
> to inquire
> about the oil.  He's going to be fed by bottle for at least another
> four weeks, before they're willing to do the test again to determine if he
> will be allowed to return to the breast.
>
> Have any of you had any experience with this situation?
>
> Debbie

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