Good morning!  PTP
I am working with a 34 y/o mother and her 6th baby.  Baby girl born at home, healthy delivery and postpartum.  Baby was born at 6lbs 13 ozs, now 8weeks old weighing 6lbs 14 ozs.  Mother state baby nurses very frequently, getting tired, hands turning blue.  Last week baby was diagnosed with an atrial-septal defect with 'significant shunting'.  To see peds cardiologist in 2 weeks.  The ped and the cardiologist are suspicious that there are possible G.I. problems, to see a ped gastroenterologist soon.  
Mother reports "dark" and foul poops.  There used to be mucous in them before mother quit dairy.  At 1 month of age the baby started having bowel movements only every 4-5 days.  Now, the baby has them only every other day or so.  She is feeding on one side until the baby quits nursing every 1-1.5 hours during day and most of the night.  She states the baby may have a 3-4 hour stretch of sleep at night.  Mom is also having problems with thrush:  red, itchy nipple; baby has white spots in the mouth.  They both started diflucan yesterday.

Her oldest child also had a a/s defect which resolved with time (no surgery).  She ended up switching to formula after being told her baby would die if she didn't start supplementing.  She is very concerned about preserving her b/f relationship with this baby.  She has started supplementing after a feed and baby will only take less than an ounce from the bottle.  I had suggested that she supplement before the feed, so that the baby doesn't get too tired.  She is using ebm and allumentum.  

Any ideas, suggestions?  
Thanks in advance!
Melissa Senf




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