Tetralogy of Fallot consists of 4 congenital heart defects:
        pulmonary stenosis (narrowing in the pulmonary artery carrying blood
                from the right side of the heart to the lungs)
        ventricular septal defect (a hole between the left and right ventricles
                of the heart)
        overriding aorta (the aorta is positioned above the septal defect)
        hypertrophy of the right ventricle of the heart

The severity of symptoms depends on the degree of these problems.

The baby will need hospitalizations for tests and surgery.  Many will tire
very easily, so feeding in ways that conserve energy will be helpful.  I
would think that breastmilk can only be good for these babies.  Work on
ways of getting enough intake without exhausting the baby. Physical growth
may be poor.  Bouts of prolonged crying could lead to cerebral hypoxia,
causing the baby to "faint."  These children should not get dehydrated, as
it can lead to cerebral thromboses (blood clots). Their blood is thicker in
an effort to carry more oxygen.  As they get older, they are more likely to
have episodes of cyanosis (turning blue).   The children characteristically
squat down to rest, once they are walking.  Although I cared for many such
babies, it was years ago, so someone currently working with hospitalized
infants can share current care protocols.  The LC can do much to give
support to the parents, and help with feeding positioning and use of
breastfeeding aids to allow for adequate intake without overtiring the
baby.

Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI
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