Infant calorie/volume/weight gain calculator. Professional Source

Pediatric Critical Care Columnist · Jun 9, 2011

Try this: http://pen.sagepub.com/content/30/1_suppl/S21.abstract (Pediatric Enteral Nurtition)

This baby would benefit from jejunal feeds which would reduce the emesis. (You can't barf from your small intestine.)

Sehille4774 · Jun 9, 2011

Thanks so much!

We are really trying to avoid the N-J tube... I am working in the home setting and this baby pulls that NGT out a few times a week--she hates it is sensitive to the adhesive even with a skin prep. We would be making many extra trips to the hospital...but it might end up coming to that.

Thanks for the good sources

Sarah

Pediatric Critical Care Columnist · Jun 10, 2011

Have the parents been offered a gastrostomy and fundoplication? I'm surprised she's 10 months old and hasn't had this done already. Here it would have been done in the second or third month of life to reduce the unplanned extubations and to ensure a secure method of enteral feeding. If the fundoplication fails to resolve the vomiting then the GT would be converted to a GJ and away we go.

Sehille4774 · Jun 10, 2011

I dont know if she would be a candidate for the the nissen/fundoplication..but she can't get a GT at this time. They started to close it surgically in stages..they even fully closed it but shortly after the final surgery, the wound opened up. So they grew a skin graft and covered the entire area with the graft...which is covering most of her abdomen and the organs still protruding. And now they are going to wait for a year or so for her to grow more before going back in and surgically. The Dr said that they dont have anywhere to place a GT.

This is a great case though. She is expected to outgrow all of her problems and have a normal life.

Going to see the nutritionist and surgeon Monday..well see what they say about it all.