In a message dated 1/12/2005 10:50:48 AM Eastern Standard Time,
[log in to unmask] writes:
But seriously, how SHOULD I handle the situation of the malnourished 8 month
old, who is not FTT enough to go in the hospital?
I would ask the mother to give me a dietary recall of what the child has
eaten for the past few days, and ask if that is typical. How often she is nursing,
how long, how does she know when the baby is finished nursing, what meds is
she on, who else lives n the home,etc should also be asked. How about asking
about lifestyle-how much is she with her baby during the day? Who feeds the baby
when she is away? What do they feed the baby? What does she and the rest of
the family eat? This child should be eating food as well as nursing, so I
would see if she is receiving WIC vouchers, Food Stamps, Food Bank, etc and
educate her on how to feed her baby. I would educate her that she doesn't need to
buy baby food, but she can mash up green beans, sweet potatoes, peas, carrots,
etc and feed to the baby. An 8 month old can even be fed ground up noodles,
oatmeal, rice etc. Educate her that feeding the baby from the table is alot
less expensive then baby food. For example, sweet potatoes cost about 25 cents/
lb, but a 4 oz jar of baby food sweet potatoes cost about 50cents. So buy 2
lbs of fresh and feed the whole family. These foods are available from WIC
and/or the local food pantry. Education should be the key here, not a sample of
formula that will be gone in a few minutes and she will have no resources to
draw on to prevent the problem again. A sample of formula is just that, a quick
fix, not a solution to the problem. To paraphrase a saying, remember, "You
can give a man a fish to eat for the day or teach him to fish so he can eat for
a lifetime".
I worked in public health for years and we had to sometimes go to the
kitchen and get something to feed a child. I usually would grab an apple, peel it,
pop it in the microwave for a few minutes, mash it up and show mom how fast and
easy it is to feed a baby from the family's food stores. Or show her how to
mash up a banana to feed the baby.
Barbara Whitehead, BS, IBCLC, RLC
eastern NC
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