MAILBAG

How Much Enzymes?

Dear Friend from Lebanon,

Thank you for your question. This is actually quite difficult to answer because everyone has different enzyme requirements. However, your individual dose requirement can be worked out according to your symptoms. Pancreatic enzyme supplements are required in cystic fibrosis mainly because of their lipase content (the fat digesting enzyme). Therefore your Kreon needs to be taken with all meals, snacks and drinks that contain fat. The more fat in the food/drink contain, the higher the dose of Kreon required. For example, fried fish and chips would need a higher dose than roast chicken and vegetables. Unfortunately, it is impossible for me to say what your doses are, as everyone is different. It is best to start with a low dose and gradually increase the dose according to the fat content of what you are eating and the control of symptoms indicating fat malabsorption. You should aim to only have your bowels opened once to twice daily and stools should be a normal darkish colour and not pale, greasy or fatty looking. If you are cautious in increasing your dose of Kreon you should not end up taking too many. The most common symptom of taking too many is constipation and abdominal pain. In the UK, we advise that the intake of Kreon should not exceed one capsule per kilogram body weight. This would mean a maximum of 43 Kreon per day for you. Many patients however do not need to take as many as this and your deal dose should be worked out as I have described above.

I hope that this answers your question
Kind Regards,
Sue Wolfe, Nutritionist

What do I feed my baby?

Dear Dr.

My baby is 7 months 2 weeks old, she weighs 7.300 Kg (16.09 pounds), and is 70.5 cm tall (27.7 in). She weighed 6.200 kg (13.66 pounds) when she was 4 months, 6.500 kg (14.32 pounds) when she was 5 months, 6.800 kg (15 pounds) when she was 6 months, and in her 7th month she weighed 7.300 kg (16.09 pounds) and her cranial perimeter was 43 cm (17 inches). I am worried about her feeding. What is advisable? At this moment I am giving her the following:
Milk + cereals. Between 592 and 739 cc (4.16 - 5.20 Gills) per day.
Supplement: 44 cc (0.31 Gills) of pap made with potatoes and vegetables, milk and butter, 44 cc of stewed peach.
Could you tell me what I can give her to increase her weight? How much milk should I give her on average per month? How many cc's of supplements? In case of using olive oil, how much could I add to her food?

Thank you,
Milagros Cardenas
Lima, Peru

Posted - Jul 16 2004: 20:20:03

Dear Milagros Cardenas,

Thank you for your question regarding the growth of your baby and how much she should be eating. I have plotted your growth measurements on an English growth chart. From this I can see that she is a long baby and that her weight gain has been normal over the last two months. This all indicates that at the moment she is receiving adequate nutrition for growth, which is very good. At her age I would expect her to be drinking at least 600mls of formula milk a day, which from your figure she is. I would also expect that she should be having food (of the type you describe) three times daily. As she gets older, her food intake should increase rather than her milk intake so she moves towards the type of diet a young child would have. If her weight gain slows down the most important thing would be to make sure that she is digesting dietary fat adequately. You do not mention whether she takes pancreatic enzyme supplements, however presuming she does the dose should be adjusted so that she has normal formed stools that are not greasy or fatty. If her weight gain is still poor (which it isn't at the moment) you could try adding some olive oil to her food, as you mentioned. One teaspoon (5cc) per food item will be enough. Remember that this is 100% fat and therefore if your little girl takes enzymes the dose will have to be increased if olive oil is added.

I hope that this response reassures you and answers your question.
Kind Regards,
Sue Wolfe, Nutritionist