Peds Clinic

I spent the day in the outpatient pediatric GI clinic today and loved it! The RD who I was with was problem-solving all day, so that patients can actually implement the nutrition care plans that she or another RD had come up with. The most striking example was one delightful 5-year-old girl with autism who hadn't grown in a couple of months. Mom said had her G-tube feeding almost entirely because she was eating so well. In fact, her dietary recall showed that she was eating enough to meet her estimated nutrient needs. However, it obviously wasn't enough for growth, so the RD suggested that she run tube feeds overnight. Mom said she would, but then Grandpa jumped in and said "Didn't you stop the tube feeds because you found the tube wrapped around M's neck one morning?" Apparently she moves a lot in her sleep and is not verbal enough to call for help if she did start to choke. This totally legitimate concern would probably have prevented mom from actually running the TF overnight. So we came up with a new way to bolus the formula to meet her needs, avoid overnight feeds, and not be too inconvenient. This little girl will be back in a few months so we can see how it is going.

The stories are still super sad: a baby who tested positive for cocaine at birth and has possible fetal alcohol syndrome, 2 ex-24 weekers with cerebral palsy, etc. But these kids seem like the lucky ones who have caregivers who are taking them to appointments and doing the best they can to meet their needs.