Dear Heather,

About 15 years ago, I worked at a hospital where we
cared for long-term ventilated babies & children.
Some lived there for up to 5 years before a home
medical foster care program was initiated.  Anyway,
our children often had G-tubes as they had strong
issues concerning oral aversion & difficulties
maintaining their airways.

As the infants grew into toddlers, we supplemented
their formula with baby food.  There wasn't the array
of pediatric "complete" forumlas that are so common
today.  The diets were managed by the nutrionists to
be sure they received the proper amount of calories,
fat, protein, & nutrients.  Strained infant foods were
blended in with formula.  Our children, unfortunately,
had no access to breastmilk once their mothers
returned to their homes hundreds of miles from our
facility.  Would this be a possibility in this
situation?  Meet with the nutrionist/dietician & call
in the physicians & whoever else is in support to
discuss supplementing the donor breastmilk/formula
with blended real food?

If she doesn't grow adequately, other measures could
be taken to add calories, protein, etc.  Our only
problems came up when the children were given
orange/yellow vegetables too often & a couple of the
kids developed a temporary orangeish cast to their
skin tone due to carotene.  Hagan's stools will still
become firmer & stinkier with the addition of "table
foods", but hopefully this could be a compromise where
she could still receive the advantages of donor
breastmilk.

Best wishes,

Linda Madsen, RN, IBCLC

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