Hi,
this is the first time I have posted but have been lurking for a couple of 
months. I am a midwfe and infant massage instructor as well as an IBCLC. I 
work in a small private hospital that usually only has low risk clients, 
predominately as a childbirth educator and see private clients  in their homes 
for infant massage and breastfeeding support. The vast majority of my clients 
have  positioning and attachments difficulties often following inductions, C 
sections, epidurals and pethidine. The client I am presently seeing (permission 
to post given) delivered via C section   at 37 weeks weighing 2.4kg initially 
breastfeed well but quickly tired, cardiac abnormalities diagnosed on day 3 
mother describes abormality as transposition of major blood vessels of the 
heart The baby was transferred to a large teaching hospital where he was 
gavaged feed and discharged  home at two weeks on expressed breastmilk 
given via a bottle. He will have surgery in approximately 2 months time. In the 
mean time mum was encouraged to monitor weight gain in consultation with a 
local government home nursing service. I become involved as  mum wanted to 
learn baby massage but as soon as I arrived at her home she said she wanted 
to try the baby at the breast which we did. He feed beautifully with lots of 
rythmic sucking with swallowing heard, mum  has very good milk supply. He 
has been to the breast for most feeds over the last 24 hrs, no color changes 
no respiratory difficulty. I have had minimal experience with babes with heart 
problems and paeditrician expected babe to bottle feed but mum is adamant 
that she wants to feed at breast. Any suggestions regarding  what mum and I 
should be watching  for or expecting would be appreciated. 

Tracey

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