to all,    A few have mentioned respiratory and cardiac probs as a possible
etiology for the tachpnea (fast breathing).  Although I'm sure you are
convinced that the baby is breathing to fast for comfortable feeding or you
wouldn't be writing, some in the field may be thrown off by "periodic
breathing" in the newborn which in some babies can be very exagerated and
disconcerting if caught in the huffing, puffing stage. By this I mean that an
occassional NB has a very noticeable pattern of this whereby they have
periods of very quick, shallow breathing coupled with periods where they
appear almost apneic. We all have, I'm sure, seen this to some degree. If
caught in a prolonged huff/puff period, the baby may appear to have a faster
rate than is true.
Weight gain despite poor feeding, tachypea could also suggest, as mentioned,
a severe cardiac defect (it would need to be severe in order to cause wt.gain
d/t CHF at this point) but would most likely also be accompanied by lethargy,
poor tone and skin color and almost certainly a cardiac murmur, which would
have been picked up at one of the pedi visits (hopefully).
Good Luck and let us know how it stands.
Lynn Shea Rn,Bsn,Ibclc
Franklin, Massachusetts

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html