Managua, Nicaragua—In clinic today we met Dara, a two-month-old cleft lip and palate baby whose mom was very concerned that she wasn’t gaining enough weight. Dara had been having diarrhea for a week, which her mother attributed to the recent heat wave. Apparently this is an old wives’ tale in Nicaragua—they think that heat will cause their children to have diarrhea. The best I can figure is that when the children have diarrhea, if it’s particularly hot outside they can easily become dehydrated, which only exacerbates the problem. Geovanni, the nutritionist for the unit, explained that the heat is likely not what is causing the diarrhea and advised Dara’s mother to inform the physicians of her daughter’s diarrhea.
Another obvious problem that Dara had been having was her inability to latch on to the nipple of her bottle. I observed Mom literally squirting formula into Dara’s mouth, and Dara was having none of it. It took us a few minutes to deduce that Mom had only been inserting Dara’s acrylic mouthpiece just prior to meal times, when she was supposed to be wearing it during all waking hours. Geovanni reinforced the importance of Dara being comfortable with wearing the mouthpiece consistently so her sucking reflex could improve.
Luckily, Dara is in the 50th percentile in weight for her age, so she is not behind in her growth, but it’s still good that we were able to correct this problem early on.