tada
Nissen Fundoplication
Pregunta
Three-week-old girl had a Nissen Fundoplication. Now, at two years of age, she is currently tube fed with Pediasure. Her family is hoping to start the transition to oral feedings. Current medications include Prevacid and doctor wants to begin Reglan when diarrhea subsides. The child's mother is concerned that her daughter went through a growth spurt early on and has had little growth since
1 - What formulas are recommended for individuals with CdLS other than Pediasure
2 - What pureed foods can be offered for variety
3 - Are there long-term nutritional suggestions to encourage growth/thriving
4 - Should her mother be concerned or take action in regard to current growth retardation
5 - Is it common to have a growth spurt and then stop
6 - Doctor is considering a Nissen redo. Is there a clue to determine when a wrap has failed in a child who has always been able to vomit past the wrap
7 - Would they benefit from an open Nissen rather than a Laparoscopic so it will not fail again
8 - What does Reglan do? Is it safe?
Respuesta de nuestros expertos
This child may need a second opinion. It is not really in her best interest to answer so many complicated and intertwined questions without seeing the record and the child. In general, when a child is not growing, there is a need for more calories. Pediasure is fine, but occasionally one formula works better than another. Pureed foods are fine, but have less nutritional value than pediasure. A growth curve should not stop and start. Was the initial fundoplication laparascopic? A redo cannot be done laparoscopically, generally. There is scar tissue. Fundoplications done early by any technique may not last for years. There are many inter-related problems here, and they should really be addressed directly. Anything less will potentially hurt her. The first step would be to schedule a sit-down session with their gastroenterologist and their surgeon, and discuss the issues and these questions
DP/TK 7-13-10
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