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Old 01-19-2012, 06:03 PM   #1
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Question about thickening breast milk...

We found out on Tuesday that our 6 week old baby is aspirating thin liquids. The speech pathologist instructed us to give her pumped breast milk thickened with rice cereal (1 Tbsp/2 oz). Yesterday she only took 14 ounces, and she is on track to take about the same today. She will only take 1-2 ounces about every 2-2.5 hours. She sleeps 6-7 hours at night. I took her to the ped today, because I thought there was blood in her diaper. The ped thinks that it is actually urate crystals from being a little dehydrated. She told us not to change anything for now and to see if she will start taking more on her own over the next few days. (She has been EBF until Tuesday.) We have a weight check scheduled for next Wednesday, and we are supposed to call if we continue to see the discoloration in her diaper. I am concerned that the rice is filling her up too much. The speech path. is supposed to call me tomorrow, but I am wondering if there is another thickener that wouldn't be so filling? Is it possible that she will start taking more on her own?

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Old 01-19-2012, 06:43 PM   #2
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It may be an adjustment period. That's a tough one. She needs the thickening since it keeps her safe from aspiration pneumonia, but she needs enough fluids. What nipple are you using? You may need a faster flow (level two or even three depending on the thickness), as thicker liquids flow more slowly. She may also need more frequent feeding due to fatigue while she adjusts. I know for adults they make thickening agents, but don't know what's in them. Good luck!
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Old 01-19-2012, 06:54 PM   #3
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Re: Question about thickening breast milk...

Thanks for responding! She is supposed to be using level 1 nipples per the speech path. On the first day she could not get anything out of them, so we switched to level 2 nipple yesterday. Then this morning she was taking 1-2 ounces in less than 10 minutes with the level 2, so I switched her back to the level 1. She seems to be doing fine with the level 1 now. We have tried to feed her more often, but she won't really eat until she starts giving us her hungry cues.
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Old 01-19-2012, 09:00 PM   #4
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I would keep the SLP and ped in the loop together to monitor this and get her to eat as much as you can! Good luck!
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Old 01-19-2012, 09:03 PM   #5
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There is this stuff simply think that I had to order online to thicken my breast milk because I was told cereal doesn't thicken breast milk the same way it does for formula. Just wanted to let you in case you had issues thickening with the cereal. I hope your little one feels better soon.
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Old 01-20-2012, 08:40 AM   #6
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Originally Posted by AngelTV83
There is this stuff simply think that I had to order online to thicken my breast milk because I was told cereal doesn't thicken breast milk the same way it does for formula. Just wanted to let you in case you had issues thickening with the cereal. I hope your little one feels better soon.
I think that stuff was recalled? I work in the NICU and we thicken with rice cereal
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Old 01-20-2012, 03:20 PM   #7
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Re: Question about thickening breast milk...

My eldest had severe reflux and would choke and turn blue and ended up on an apnea monitor. We had to use lots of cereal in his bottle and my youngest has the same issues. It does fill them up faster at first but they adjust to it. I stopped breastfeeding really early b/c he absolutely could not hold breast milk down even thickened. Just keep a really close eye on your lo and pray that her tummy gets adjusted to the cereal soon!

Have you tried simply inserting a sterilized needle in the hole of the level 1 nipple to allow just a slightly smaller amount through. Maybe she is working so hard that it tires her out. It took a bit to find the perfect nipple hole size my my youngest. When it was too small he'd just give up and stop eating.
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Old 01-20-2012, 03:21 PM   #8
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Re: Question about thickening breast milk...

Also, the sudden cereal can cause some constipation and generally harder stools, just an FYI. After they get used to the cereal though the constipation usually goes away!
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Old 01-20-2012, 04:39 PM   #9
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Oh I didn't know my daughter used it 5 years ago
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Old 01-22-2012, 02:12 PM   #10
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Re: Question about thickening breast milk...

The stuff that thickens breastmilk is called Simply Thick. There was a recall on it because they didn't file the correct paperwork, but it is still on the market. It should not be used on babies that were born before 37 weeks, but it is the preferred thickener at Children's Hospital Boston. Breastmilk has enzymes in it that will break down rice cereal and make it an incorrect consistency.

Has she had a swallow study? It would be the best way to find a functional, safe level of thickening and flow. My daughter has been on thickened fluids (breastmilk until 6 months) for almost a year now.

ETA: My daughter was originally put on an NG tube (only had it for 2 weeks) because she wasn't originally taking in enough fluids when it was thickened. It's a lot of extra work. An added benefit of using Simply Thick is that it is just water and xantham gum (you can actually find recipes to make your own on-line if you were weary of the purchased type) so it is also hydrating.

Last edited by jennyfa; 01-22-2012 at 02:16 PM.
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