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Feeding Tubes

Domanda

My child suffers from chronic reflux and takes Prevacid. After over two years with medication, doctors want to do the Nissen, which is fine with me, but they also want to put a feeding tube. Main reason is so that he grows and thrives. He doesn't eat much, mostly PediaSure, but he is overall healthy. Tiny, but healthy.

Risposta dei nostri esperti

G-tubes are a good idea after a fundoplication. Children sometimes can't or don't eat well after surgery and it will help. They are also be used for supplemental nutrition. You are never going to make your child big; our aim is not to make him fat, but good nutrition (adequate weight or height) does allow children to fight infections better, heal better, and have overall better health. G-tubes are also very easy to take out again-sometimes without a trip to the Operating Room. I usually have kids keep their G-tubes until they haven't used them for at least 2-3 months

CP/TK 7-13-10

Approvato daClinical Advisory Board (CAB)
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Raccomandazioneinformation

Reflux

R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.

Raccomandazioneinformation

Feeding and Dental Difficulties

R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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