Pui Tong 10/29/2013 Case Conference #2 1. ID# 53773241 (1 year ol c!il "# $%%oin&'en&( )*+ ()eal&!

, *u&ri&ion +% a&e" Par&ici%an& -oug!& in oc&or.s 'e ical ocu'en&a&ion re/es&ing Pe iasure for c!il ue &o 0I isease. Par&ici%an& sai c!il is on &u-e oc&or.s office fee an curren&ly !a1e %ro-le' ea&ing foo . I calle

an s%o2e &o oc&or 3a&!erine 4eng. Doc&or 4eng sai &!a& &!e c!il !as ys%!agia as 5ell as 0I isor er an &!erefore is curren&ly %lace on &u-efee . 6!e also sai &!e c!il s!oul only -e %lace on li/ui s suc! as %e iasure an 'il2 an foo s!oul no& -e gi1en &o &!e c!il . $l&!oug! &!e 'o&!er sai s!e is slo5ly in&ro ucing %uree foo an sof& foo s &o acco''o a&e &!e c!il .s 0I &rac&7 I reco''en e &!a& s!e follo5 !eal&! care %ro1i er.s ins&ruc&ions an %lace &!e c!il on *P8 un&il fur&!er no&ice. I ga1e &!e %ar&ici%an& a ne5 'e ical ocu'en&a&ion &o -e fille ou& -y &!e oc&or regar ing &!e c!il .s 'e ical s&a&us for &!e ne9& a%%oin&'en& as 5ell as re'o1ing all foo i&e's on &!e :IC foo %ac2age e9ce%& for 'il2 an Pe iasure. (T!e %re1ious nu&ri&ionis&s all ga1e &!e c!il co'%le&e :IC foo %ac2age an no no&e 5as 5ri&&en regar ing &!e c!il .s 'e ical s&a&us." 2. PC*$ core ele'en&s +&ili;e cri&ical &!in2ing an %ro-es a%%ro%ria&ely &o collec& an analy;e rele1an& infor'a&ion. <ase on 5!a& &!e oc&or in ica&e on &!e c!il .s 'e ical ocu'en&a&ion7 I 5as a-le &o acer&ain &!e c!il .s curren& fee ing 'e&!o . I %ro-e &!e %ar&ici%an& an as2e all rela&e /ues&ions regar ing &!e c!il .s curren& fee ing rou&ine &o ensure 5!a& &!e %ar&ici%an& is saying 'a&c!e &!e oc&or.s iagnosis of &!e c!il . 6ince c!il is curren&ly

on &u-efee an is %lace on a &!in li/ui s ie&7 I re'o1e all foo fro' &!e :IC foo %ac2age &o ensure c!ec2 issurance reflec&e c!il .s fee ing s&a&us an confor' oc&or.s ie& or er. :or2 5i&! %ar&ici%an& &o %riori&i;e nee s an concerns. Par&ici%an& 5as concerne a-ou& &!e c!il .s %ri'ary for' of nu&rien& in&a2e. I e9%laine &o &!e 'o&!er &!a& s!e nee s &o follo5 &!e !eal&! care %ro1i er.s ins&ruc&ions an con&inue &o %lace &!e c!il on &u-e fee 5!ile fee ing li/ui s suc! as 'il2 an %e iasure. $l&!oug! I 5as no& a-le &o gi1e &!e %ar&ici%an& a co'%le&e :IC foo %ac2age7 5e a resse !er concerns a-ou& &!e c!il .s nee s an I e9%laine &!a& I 'us& follo5 !er oc&or.s ins&ruc&ions as 5ri&&en on &!e 'e ical ocu'en&a&ion an only issue 'il2 an %e iasure as in ica&e . Docu'en&s all 'an a&ory infor'a&ion an 7 -ase on %rofessional =u ge'en&7 non>'an a&ory infor'a&ion. $s in ica&e in &!e c!il .s 'e ical ocu'en&a&ion7 I 5ro&e a no&e 5i&!in :IC6I6 regar ing &!e c!il .s curren& 'e ical con i&ion an &!e reasons for issuing only 'il2 an %e iasure for !er :IC foo %ac2age. $ll %er&inen& infor'a&ion 5ere ocu'en&e carefully 5i&!in nu&ri&ional , -e!a1ioral a&a sec&ion of :IC6I6 as 5ell. ?ee ing 'e&!o 5as c!ange &o s%oon fee an &u-e fee reflec&i1e of c!il .s 'e ical s&a&us. )eal&! an 'e ical con i&ion of &!e c!il (0as&roin&es&inal isor er an ys%!agia" 5as en&ere in &!e clincial sec&ion of :IC6IC7 &u-efee 5as in ica&e in &!e s%ecial ie& !is&ory. $ll rele1an& infor'a&ion 5ere en&ere accor ing &o c!il .s 'e ical con i&ion an 'a&c!e curren& fee ing 'e&!o .

3. @y &!oug!&s T!e %re1ious nu&ri&ionis& s!oul calle &!e oc&or in or er &o &!oroug!ly ocu'en& &!e c!il .s fee ing con i&ion. 6&aff s!oul also use cri&ical &!in2ing s2ills &o 'a&c! c!il .s 'e ical con i&ion 5i&! :IC foo %ac2age. 6ince c!il is on &u-efee 7 all :IC foo s e9ce%& &!ose in ica&e -y !eal&! care %ro1i er s!oul -e re'o1e &o %ro%erly reflec& curren& fee ing -e!a1iors. 4. ?ee -ac2 an sugges&ions Par&ici%a&ing s&aff a& &!e case conference agree &!a& &!e oc&or s!oul -e calle if &!ere 5ere any iscre%ancies -e&5een &!e c!il .s 'e ical con i&ion7 'e ical ocu'en&a&ions an &!e %aren&.s s&a&e'en&s. $ny iscre%ancies an %er&inen& infor'a&ion s!oul -e 5ri&&en in &!e no&e sec&ion 5i&!in :IC6I6 in or er &o aler& &!e ne9& nu&ri&ionis& regar ing c!il .s con i&ion. 6i&e 'anager $'y sugges&e &!a& if conflic& arise 5i&! &!e oc&ors7 &!e %ar&ici%an& s!oul -e allo5e &o s%ea2 &o &!e oc&or on &!e %!one &o 5or2 ou& a %lan of ac&ion -e&5een &!e &5o.