We are seen in the dietary clinic today by the dietician. I'm not feeling too happy about this appointment. I'm feeling a bit judged. I know my children are getting a good balanced diet and I don't need a professional to tell me if I'm doing it right or wrong. My feelings are confirmed when the dietician takes one look at B and wonders why we are wasting their time! I do so love being right.
Due to the lack of measurements it's difficult to gather a clear picture of his weight and length history and plotting errors on his chart (apparently). He has decreased in length which is not true! They made a note of his feeding history and we reported a good appetite and a detailed food diary. His diet is nutritionally balanced and varied. The dietician feels his diet his adequate for appropriate growth and therefore if his growth remains an issue then it may not be due to his eating problem. His weight gain is starting to increase and she hopes the trend will continue. The goals: include at least two iron rich foods per day and ensure regular meals are given including high fat foods such as oil, cream, full fat dairy products. They are satisfied and a follow up appointment has not been arranged.
I'm feeling slightly smug at this point but still none the wise as to what the true extent of B's problems are and it's back to the drawing board.
tots100
Showing posts with label dietician. Show all posts
Showing posts with label dietician. Show all posts
Monday, 26 October 2009
Friday, 27 March 2009
Letter from the health clinic
Just after B's first birthday I get a letter following up the appointment at the health clinic. They list the "problems" as concerns regarding motor delay, faltering growth and puffy feet.
The specialist registrar reports that B is hungry and ratty but settles after a breastfeed. He seemed active in the clinic but he's not that active at home. She says he appeared pale but his conjectiva were pink. He had a small anterior fontanelle but was well perfused centrally. She noted B had purple swollen feet that were cold to touch. I told her they are always like this and it doesn't matter how many pairs of socks that you put on him, he continues to have cold puffy feet. He has some excema on his feet and I told her that he has previously been treated for a fungal infection of his feet. His peripheral pulses were normal and his femorals were of good character and volume.
His heart sounds were normal and chest was clear. His abdomen was soft and non tender with no organomegly. His neurological system as grossly intact with normal power tone and reflexes. There is no evidence of wasting. His buttock muscles looked normal and there seem to be normal hip creases. Still pointing out his weight growth and without having anything to compare it too (I didn't have him weighed at all since birth) she can't assess whether or not this is genetically where he is meant to be. She has no explanation for his cold purple puffy feet at present.
She mentions again that she is confused regarding his cold puffy feet and has included autoimmune profile in the blood works. She is referring B to the Physiotherapists so they can see him regarding his gross motor delay. I don't want to see a dietician and she agrees that this is acceptable given his dietary history appears appropriate for his age. I promise to use follow on milk instead of cow's milk from now on at home.
The specialist registrar reports that B is hungry and ratty but settles after a breastfeed. He seemed active in the clinic but he's not that active at home. She says he appeared pale but his conjectiva were pink. He had a small anterior fontanelle but was well perfused centrally. She noted B had purple swollen feet that were cold to touch. I told her they are always like this and it doesn't matter how many pairs of socks that you put on him, he continues to have cold puffy feet. He has some excema on his feet and I told her that he has previously been treated for a fungal infection of his feet. His peripheral pulses were normal and his femorals were of good character and volume.
His heart sounds were normal and chest was clear. His abdomen was soft and non tender with no organomegly. His neurological system as grossly intact with normal power tone and reflexes. There is no evidence of wasting. His buttock muscles looked normal and there seem to be normal hip creases. Still pointing out his weight growth and without having anything to compare it too (I didn't have him weighed at all since birth) she can't assess whether or not this is genetically where he is meant to be. She has no explanation for his cold purple puffy feet at present.
She mentions again that she is confused regarding his cold puffy feet and has included autoimmune profile in the blood works. She is referring B to the Physiotherapists so they can see him regarding his gross motor delay. I don't want to see a dietician and she agrees that this is acceptable given his dietary history appears appropriate for his age. I promise to use follow on milk instead of cow's milk from now on at home.
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