Weight gain of baby

Question

Hello
our son had a tube from June to December, but he can no more stand the naso-gastric tube (vomiting...), we have removed it since mid-December and since then his weight stagnates despite substantial eating and increase of Creon. Do you think that we should consider a gastrotomy until the weight gain is going to start again?
Thank you.

Answer

Hello,
To maintain good nutrition is essential in the context of cystic fibrosis to obtain normal growth, and a child full of energy, more resistant to infections. Energy requirements are increased in CF, and sometimes food intake, even if substantial, is not sufficient to cover the needs. Initially, the dietitian can advise enrichment of meals or oral calorie supplements according to the age of the child. Also, check the proper control of pancreatic insufficiency by taking pancreatic extracts that are needed, and look for other causes of poor weight gain. If despite this, weight stagnates, support of enteral nutrition is essential, even if it is never final. Poor tolerance of the nasogastric tube incite to propose a gastrostomy for nutrtion, possibly associated with an anti reflux therapy if necessary. This gastrostomy then will bring enough energy (or calories) to restore a satisfactory nutritional status. Feel free to discuss this important issue with the CF team of your child.
Sincerely
Dr Michèle Gérardin

08.03.2015