[Dysphagia] thickening breast milk

[Kate.Farabaugh at BannerHealth.com (Kate Farabaugh)]

Hi Eva
Unfortunately it is the concept of thickening formula or breast milk in infants being used pervasively without proven benefit that concerns me the most. 
If one would read the baby and not make them eat 8 oz every 4 hours but would allow them to eat 2 oz every 2 hours, they would not reflux and their gastric system would be being exposed to "solids" prematurely! The infant gastric system is not ready to digest rice or xanthum gum before the estimated 5 month age.
Unfortunately, good intentioned but poorly informed MDs and clinicians overly prescribe "thickening" when it just isn't necessary and is hurtful to the infant. 
These babes do "talk" to us and do "tell" us when they have had enough and will gain weight if we just "listen" to them and don't overfill them at each feeding. 
Okay, I will hop off my soapbox now and let others jump on!!
Have a good one!


Kate Farabaugh, MA, CCC-SLP
Pediatric Rehab Manager
NCMC/Banner Health System
970.350.6155
FAX 970.378.3858

WARNING: This message, and any attachments, are intended only for the  use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law.  If the reader of this message is not the intended recipient or employee/agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of the communication is strictly prohibited.  If you receive this communication in error, please notify us immediately. 
kate.farabaugh@bannerhealth.com

>>> "Eva West" <epwest@sympatico.ca> 07/07/04 06:38PM >>>
I do not specialize in pediatrics, but I do see a number of infants
throughout the year.  The usual reason that I see for pediatricians ordering
thickened milk for infants is gastro-esophageal reflux (normal in smaller
amounts - "spitting up") that is so excessive that it is decreasing
available milk to the infant and affecting weight gain.  It apparently
doesn't stop the reflux, but reduces the amount that is refluxed enough
allow better weight gain. The usual thickener I see being used for formula
is infant rice cereal, but occasionally a pre-thickened formula such as
Enfalac AR.  
Because of enzymes in breast milk, rice cereal won't thicken it, and so I
have heard of Simply Thick (Xanthan Gum) being used.  I have personally
never had a client using it though, so I can't comment.  
It should be noted that thickening milk does not work for all babies with
excessive reflux.  It should also be noted that the babies that I have seen
on these thickeners generally are NOT having any sort of swallowing
difficulty, and they are NOT aspirating or having any respiratory problems
associated with the reflux, so what happens if it enters the lungs isn't
really an issue.  The issue is nutritional - they just spit back too many
calories!
Eva West RD

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of sorriso@adelphia.net
Sent: July 7, 2004 7:46 PM
To: dysphagia@b9.com
Subject: [Dysphagia] thickening breast milk

There was a post today on the ASHA Division 13 listserv asking about how to
thicken breast milk.  Given the debates on this list about thickening
liquids in other populations I was wondering what the consensus is about
breast milk.  So far no one has offered a solution that works and no one has
questioned why it's needed in the first place.

I'm hoping this starts a lively conversation!

Linda A. Zanchi, MA CCC-SLP


_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia


_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia