Forwarded message:
From:     Self <abdoctor>
To: [log in to unmask]
Subject: infant cardiomyopathy/low weight gain
Reply-to: [log in to unmask]
Date: Thu, 2 Jan 1997 17:29:16

I am seeking for suggestions for maximizing  weight  gain in a
14 month  baby suffering from idiopathic cardiomyopathy.  Babe was
found to have heart disease at her one year check-up.  Parents
(mother-physician, father-P.T.) had been concerned about slow weight
gain and placid behaviour.  Heart damage significant and is probable
candidate for heart transplant-will need to move to Toronto for this.
Under care of pediatric cardiologists in Vancouver Canada, but
living in our isolated town (5hours to Vancouver).  Currently on
digoxin and fuorosemide.  Just started metoprolol.  Weight gain has
been unsatisfactory with recent drop.  Pediatric cardiologist
supportive of  breastfeeding , although some care providers would
prefer to be able to more easily quantify input.   Mom wishes to
continue breastfeeding and willing to try suggestions for increasing
caloric intake.   She wondered if caloric density of her milk could
be manipulated.  Milk production good.  Baby has little appetite.
Short frequent feeds.  Baby has never accepted bottle.  No longer
very interested  in solids, but nurses for comfort.
 Discussed upright positioning, pumping off foremilk and then
feeding, pumping hindmilk to feed by cup (will only take a few sips).
Has tried SNS but baby didn't care for it.

As we live in a small town my only experience with breastfeeding
counselling for a cardiac baby was Tetralogy of Fallot many years
ago, and am so glad to have 1000 people to ask for advice!

I would appreciate both specific advice to enhance weight gain and
suggestions which may be useful in the care of this ill baby.

I have posted to LACTNET in the past, but since it has been a while I
am an IBCLC (1987-resitting exam this year), and a dental hygienist.
I work part time for public health and at the community breastfeeding
drop-in.  Mother of 4 breastfed children.