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Child has double outlet right ventricle in heart and cleft palate. Diet to gain weight

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Dr. Uma Rajah Ananth

Pediatrician, Neonatology

Practicing since :1970

Answered : 891 Questions

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Posted on Fri, 1 Mar 2013 in Child Health
Question: HI

My 4 1/2 month baby have double outlet right ventricle in heart and cleft palate ,
She is not able to gain weight , her current weight is 2 KG , please suggest the diet chart to gain her weight.
Please note she is having severe cough because of that she VOMIT out milk most of the time in a day.

Thanks
XXXXXXX
doctor
Answered by Dr. Uma Rajah Ananth 2 hours later
Hi XXXXXXX

Welcome to XXXXXXX

I have a few questions to ask in the beginning.

Does your chid have any other congenital anomalies?
Any chromosome study done?
Is the brain structurally OK?

Is there cleft lip also?
What milk baby is on?
What was the birth weight?
What is the plan by the cardiologist for surgical correction of the defect?

The cause of poor weight gain is multi factorial in your child.
1- congestive cardiac failure
2-cleft palate and feeding problem
3 use of diuretics

You are already giving MCT oil for extra calories.
The plan for your baby will be to give high calorie and high protein formula without increasing the volume much.
At the same time you have to be very careful with feeds because of the cleft palate.
After hearing from you reg my questions I can suggest some points in feeding!
God luck
Dr Uma




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 24 minutes later
Hi Dr Uma

Thanks for your quick response,here is the answer of your question

Does your chid have any other congenital anomalies?
No physical defect but have multiple XXXXXXX defects (DORV , cleft palate , single kidney )from birth


Any chromosome study done?
Not done anything after birth

Is the brain structurally OK?
still not able to find out

Is there cleft lip also?
no cleft lip only cleft palate

What milk baby is on?
NAN 1 (formula milk)she not had her mother milk from birth.

What was the birth weight?
Birth weight is 2.3 kg

What is the plan by the cardiologist for surgical correction of the defect?
Currently no plan they are waiting for baby to gain atleast 6 kg of weight

Just for your info we just started .

1) XXXXXXX dal
2) home made cerelac ( rice and greendal mix)

need your guideline to improve her weight and also come out from cough.

Waiting for your response

Thanks
XXXXXXX
doctor
Answered by Dr. Uma Rajah Ananth 21 minutes later
Hello,Thanks for the details.

I feel it is essential to rule out associated chromosomal anomalies and brain anomalies.
This is to decide about further course of action.

There is a milk called Similac special care 24 available in some places. (Abbott company.)
The has more calories (24 calories per oz instead of 20 in Nan and all more protein.
See whether you can get it.
Otherwise mct will add extra calories

Reg other semisolid food,what you are giving is OK

You can add some juices- orange and XXXXXXX

For cough

1 hope they have tried a course of antibiotics.
2 keep baby in head up position while feeding to prevent aspiration and chocking.
3 DORV itself can cause cough due to flooding of the lungs-
4 cough syrups are not of much use in this very small baby.

God bless
Good night

Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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