Hi all,
Have an interesting case that I could use some input on.  One year old boy
with Down Syndrome, nurses beautifully (!!), had open heart surgery in April
weighing 11 #, and has gained 4 # since then.  Looks very healthy, lots of
chubby little limbs, double chin, etc. but is small.  Does not take a bottle
or cup, is learning how to suck a straw.  Pedi GI doc insists on increasing
calories to this little guy, wants 16 oz of Kindercal into him per day, and
is not taking into consideration what breastmilk he's getting.  We worked
with SNS which took some sneaking to get the tubing to a location where he
didn't notice it! (He's a really bright little guy!)  But the Kindercal is so
thick, even with the largest tubing, that he's only taking 1-2 oz per feeding
that frequently must be extended to an hour.  Mom is VERY dedicated to
breastfeeding, doesn't want to NG tube this little guy to up his calories (me
neither!), and is very assertive with letting the docs know her feelings.
 Are there some other inventive ways we might get the supplement into him?
 Any input?
Thanks,
Kathy Parkes, RN, IBCLC