cofeemate or breastmilk?

shocked, stunned, shaken, taken aback, appalled, outraged!

who would not? it was the first time i heard of coffee mate being given as a milk substitute for infants..it was about this patient at the government hospital-the youngest of 8 siblings to a 24 year old mother ( she does look forty-ish, though) she was admitted for diarrhea. when i saw her in her foul-smelling bed, the poor child moaned weakly, appeared lethargic, her eyes were sunken, her lips were very dry with multiple oral ulcers and vesicular lesion on the vermillion border. her sunburned hair was very dry and thinning. For people in the non-medical field she would appear to be "well nourished"-because she doesnt look thin at all! But for md's like us, she appeared to be "poorly nourished" ironically, this is because of edema or water retention due to protein energy malnutrition or what we called as kwashiorkor. On close examination- her distended abdomen is actually due to her enlarged liver and presence of ascites or water inside the abdomen.

Aside from her physical appearance, she is suffering from a case of chronic gastroenteritis, a very common condition among children with poor nutrition.

only in zamboanga, only here where you can find children afflicted with kwashiorkor. The PPS (Philippine Pediatric Society) people thought its an extinct condition in the Philippines . At least that was according to a pediatric gastroenterologist from Manila during a special lecture on Lactose Intolerance..I wonder why? Is it under reported? Something fishy is going on here..

Is it because of Cesar Montano's ad on TV..? im very sure they were'nt promoting the product as such..but i vividly remember one particular Tausug patient i had who was suffering from meningitis, was consoled before submitting to a particular procedure..(this time its lumbar puncture) ..

"ayaw ka magtangis kaugun in luha.. parihi sin panyuh supaya makawa.. bukun da dusa ko, dusa sin mo ako nagbabayubayu.. mami man cofee mate lagak!"( stop crying, we will buy coffee mate later promise)..

...and then the child stopped crying...