Hi all,
I'm caring for a 4 month old baby with a patent foramen ovale and atrial septal 
defect.  He is on O2 and has some trouble keeping perfused while crying.  He 
was born 2 months early and never breastfed well in the NICU.  Mom reports 
they would have her pump right before an attempted feed, but that her 
letdown was so strong she would still drown him in milk.  She now is trying to 
pump as much as possible and feed the baby through a bottle as he has now 
developed reflux and she must thicken the breast milk.  I am helping her 
improve her supply as it is dwindling more and more as the baby grows.  She 
reports he hates the formula and she wants to be able to provide as much 
breast milk as possible.
What I'd like is some alternatives to the thickening agent that would allow the 
baby back to the breast (if he will go).  Mom would get better stimulation and, 
if baby can tolerate at-the-breast feeds, I'm sure he would benefit too.  What 
about probiotics for the reflux?  Her daughter also had this problem and had 
surgery to correct it, although the Mom says she hated it and would do 
anything to avoid going down that road again.

Thanks,
Denise A. Schuler BSN, RNC, CLC
Powell Valley Healthcare
Powell, Wyoming

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