[Dysphagia] difficulty gaining weight

[pressmah at sjhmc.org (pressmah@sjhmc.org)]

I would suggest that the mother be encouraged to consider that a PEG does
not preclude oral feeding.  

-----Original Message-----
From: Begg, Tenielle [mailto:Tenielle.Begg@community.nsw.gov.au]
Sent: Thursday, October 07, 2004 7:13 PM
To: 'dysphagia@b9.com'
Subject: [Dysphagia] difficulty gaining weight


I am having difficulty with a client and i was hoping that the group may
have some ideas/suggestions...
background hx: born at 36 weeks, required resuscitation at birth, bilateral
dislocated hips, multiple dysmorphic features, congential heart disease, an
undiagnosed syndrome, laryngomalacia, GOR, and has had surgery for gut
malrotation.
Presently: she is currently 12months old and weighs 10 pounds. it has been
extremely difficult puting weight on her. everytime she starts to put on
weight, she gets sick (cold/flu) and then loses the weight that she had put
on. she is fed orally and takes 150-180mL AR formula 4-5 times per day
(formula is being thickened with rice cereal). She is also taking solids
100-120gm 3 times day. dietitian has recommended 6mL MCT oil & 1 1/2 scoops
polyjoule daily.  
she lives in a rural area with limited access to services. she has been sent
away for tests (incl MRI) but no one has been able to work out why she
hasn't been puting on weight. they have discussed puting in a PEG but the
mother doesn't want one. last MBS suggested swallowing was safe and
functional with some modifications (recently sent for review MBS - awaiting
results). i would like to know where the prob is and what mechanism we are
trying to by pass before puting in a PEG in.
has anyone seen anything similar, got any suggestions on what may need
further investigation. myself and my colleagues are extremely concerned

Thanks,
Tenielle Begg
Speech Pathologist






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