[Dysphagia] thickening breast milk

[MICHAEL at email.chop.edu (Staci Michael)]

Ahhh semantics.  Reflux was conclusively ruled out by a group of us folks, including but not limited to a gastroenterologist, using a combination of tests (including a milk scan) and clinical judgement.  

I'll try to be more careful with my wording.

Still not to be addressed is the original question.  WHEN it is determined that breast milk needs to be thickened, assuming that the therapist has made a wise professional decision, what should we be using?  Can we reach a consensus on this as a field?



>>> "Irene Campbell-Taylor" <eripley@yahoo.com> 07/08/04 04:36PM >>>
If a gastroenterologist was not involved, while I agree that clinical signs are important, I can't see that reflux was "conclusively" ruled out. In an infant of this age, I would want confirmation of my clinical impressions re for example, a milk scan. Only when the clinical signs say "reflux" and the usual basic exams say "no reflux" do I ignore the latter.Pity that a milk scan can't be done during breast feeding. Joan, do you know of any ingenious method of approximating such a thing while breast feeding?

Staci Michael <MICHAEL@email.chop.edu> wrote: I never said it was ruled out by a gastroenterologist- I would never rule out reflux or other GI dysmotility based on testing alone- I look at a combination of objective test data AND clinical signs- often the clinical signs being much more of an indicator when all tests are negative- we all know how often that happens! 

>>> 07/08/04 01:31PM >>>
Staci, what tests were done to rule out reflux?
> 
> From: Irene Campbell-Taylor 
> Date: 2004/07/08 Thu PM 12:46:57 EDT
> To: Staci Michael , sorriso@adelphia.net, 
> dysphagia@b9.com, Kate.Farabaugh@bannerhealth.com 
> Subject: Re: [Dysphagia] thickening breast milk
> 
> 
> 
> Staci Michael wrote:
> Reflux was conclusively ruled out.
> 
> ** With respect - I never accept that statement from gastroenterologists. They rarely perform all of the tests required to "rule out" GER in infants, children or adults and the best that can be said is that reflux was not seen when test X was performed. I have had infants and children with clear Sandifer syndrome and classic signs of reflux identified as "GER not present." Adults with all of the classic clinical signs, the same. So a pound or two of salt is often required with that Dx especially in infants.
> 
> 
> 
> 
> 
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com 
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Dr I Campbell-Taylor
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