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Date: | Sat, 5 Nov 2011 17:54:48 -0400 |
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Erika writes:
What do you ladies know about dysphagia? I have a client who recently had
her 8 month old diagnosised with this and the children's hospital told her
that she shouldn't use breastmilk but instead use formula and thicken it. I
have never even heard of dysphagia so I thought I would see if there is
anyone with any information on this?
~~~ I'm sure there are experts who know more than I on this list, but just
to get us started: dysphagia just means having difficulty swallowing. Some
babies who have dysphagia actually have an undiagnosed tongue tie, but
others have no structural/anatomical reason for this difficulty and it may be
more related to having low tone or something else. Babies can develop this
after too much refluxing, or they can have it inherently for reasons we
sometimes can't figure out or that become evident later. I've seen some babies
whose dysphagia doesn't become evident until they reach the life stage when
they begin complementary feeding, and have to cope with solids. They may
fall off their growth arc then, or show other issues. You are right that
mother's milk is usually easier to coordinate in terms of SuckSwallowBreathe,
easier than AIM a study showed. But there are some babies who have such an
issue they cannot safely swallow even their moms own milk. Some things
suggested as thickeners don't really work with human milk because the
properties in the milk begin to digest it and it thins out anyway. There are also
things like Thick-It which is made as a food additive for those people who
really cannot swallow any liquid safely. ( Like my grandmother when she was
in her 90s, or someone after a stroke. This is used for very challenged
babies too sometimes.) One major challenge I've found is that many feeding
therapists ( OTs and SLTs,/SLPs) use bottlefeeding as the norm and only know
how to work off that. They may think breastfeeding is part of the issue, and
it often is not. ( In rare cases, as I said, nothing can really be safely
swallowed without aspirating.) When I can, I try to attend at least one
session with the OT/SLT/SLP with the mom and baby to see what their point of
view is and whether they actually know anything about normal (meaning
breast-) feeding.
Hope that helps and someone wiser jumps in with more info.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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