I've run into a situation with a mother of a newborn.  The newborn girl has
Down Syndrome and has been feeding well at the breast.  At 2 weeks of age
she was diagnosed with heart problems, A-V Canal defect and a hole, and
will need open heart surgery.  The baby started diuretics(lasix and
aldactone) on 6/17.  The Cardiologist is allowing bf for now, but stated it
probably will be neccesary to transition to a bottle because it is easier
for the infant to feed and they can mix a suppliment to increase the
calories.  When the mother answered that she had heard of studies done by
LLL that bf was easier, he replied that of course LLL is skewed in their
viewpoint, and that in his 20 years of experience he did not observe
this(of course how many mothers did he give the chance too?).  The mother
does not want to use a bottle(a LLL leader) and does not believe it is best
for her baby.  She would like to bf up to and right after the babies surgery.

Is there any information/studies that show bf is easier than bottlefeeding
an infant, especially babies with heart problems, that can be presented to
the Dr.?  What other strategies could she use to persuade the cardiologist?
 She really wants all the advantages of bf since the infant has Downs with
the problems of ear infection/speech development and mental function, not
to mention the comfort/bonding she needs at this time.

Lastly, since the cardiologist emphasis is on weight gain, what techniques
can be used to aid the baby in gaining weight and forestall
bottles/supplements?  It seems that since the baby was put on the
medication she has a good day of feeding and then a poor day of
feeding(very sleepy, can barely be roused awake, then falls asleep in
seconds).  This has alternated for the last 5 days.  They are meeting with
the Doctor on Wednesday for a checkup(EKG and weight) and will ask the Dr.
about the effects/dosage of the medication.  The dosage of medication was
calculated from the babies weight at the first visit.  She was born 6 lbs 2
oz, went down to 5 lbs 14 oz and at the cardiologist visit was 6 lbs 7 oz.
After 1 1/2 days of medication, she was down to 5 lbs 11 oz from fluid
loss.  Aldactone can cause drowsiness and the dosage may be adjusted to the
babies new weight.

Please email to the list and to me privately. Thanks.

Kathleen



Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
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