Bloom's syndrome is an autosomal recessive disorder found most commonly in individuals of Ashkenazi-Jewish descent. It is characterized by poor growth, sun sensitivity and erythematous telangiectasias of the face. These children are very poor feeders who demonstrate severe growth failure. We report two children with Bloom's syndrome in whom aggressive gastrostomy tube feeding led to marked improvement in all growth parameters and in motor development. Patient 1 was the 1340g product of a 35 week gestation delivered via Caesarian section secondary to intra-uterine growth retardation. The patient was seen initially at age 14 months. Height was 64cm and the weight 5.5kg. The child was given nasogastric tube feedings, which were converted to gastrostomy tube feeding following the placement of a percutaneous endoscopic gastrostomy two months later. The initial developmental evaluation was consistent with a 6 month level. Within 18 months, the height was 82cm and the weight 11.4kg. The repeat developmental evaluation was age appropriate. Patient 2 was the 2240g product of an uncomplicated full-term pregnancy and normal, spontaneous vaginal delivery. Tube feeding instituted at one year of age led to a doubling of weight in 15 months and dramatic developmental gains in motor development. Although the long-term benefit of aggressive nutrition cannot yet be determined, these children illustrate the need to reconsider the traditional passive approach toward nutrition in patients with Bloom's syndrome.
