On Wed, 12 Jan 2005 09:45:30 -0600, Suzanne Berman, M.D., FAAP
<[log in to unmask]> wrote:

<snip>But seriously, how SHOULD I handle the situation of the malnourished
8 month
>old, who is not FTT enough to go in the hospital?  (Outpatient workup and
>management of FTT is still the standard of care in the US.)  Y'all have
said
>specifically what I SHOULDN'T do, but what SHOULD I do?
>
<snip>
>Suzanne

At 8 months old, how about regular solid foods?  You might instruct the
parents to offer the baby many small meals throughout the day, rather than
just three meals a day with the family.  I'd ask questions to see if the
parents are using an Ezzo-type parenting program (strictly scheduled
feedings).

I can sympathize with wanting to feed an obviously hungry baby.  If the
mother is already bottle-feeding, I would want to see the baby get a bottle
while I watched.  Then I could see if the baby is having problems
swallowing or what else may be going on.

If the baby is breastfeeding, I'd want to see the mother nurse, with a pre-
and post- feeding weight check to see how much the baby is transferring.
Supplementation might be needed, but I'd want to see what was going on with
breastfeeding first.

Question for those of you with legal background...  Under the proposed law,
would feeding the baby in the office be different from "distributing" free
samples?

-Claire Bloodgood, IBCLC

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