Nope. Close, but not quite. It's "patent" (not 'persistent') ductus
arteriosis. PDAs are common in preterm kids. A PDA occurs when there is no
closure of the artery connecting the aorta (the big heart vessel) and the
pulmonary artery which normally occurs shortly after birth. PDAs usually
become apparent in the first week or so of life. And, they often (although
not always) spontaneously close around 12 weeks or so.

This is an oversimplified version of what happens: blood is shunted from
the aorta to the pulmonary artery (left-to-right shunting.) Therefore, this
additional blood is re-circulated to the lungs and returned to the heart's
left atrium and the left ventricle. This means that the left side of the
heart is working harder, and there's increased pulmonary vascular
congestion (I think of it as blood being piled up somewhere where it
doesn't belong) as well as other problems. Therefore, the baby tires
easily, because this blood is not moving the way it should be moving.

Remember that blood is made up largely of fluid. Careful fluid regulation,
by a cardiac specialist, is therefore generally required, so that this
congestion doesn't become problematic. Medical and surgical treatment can
be done for treatment, but sometimes PDAs spontaneously close.

I'm rambling longer than I think anyone should, so I'll cut to the chase
here: This is a serious medical condition, and it can't be managed simply
as a "breastfeeding" problem. The baby *does* tire easily because he has a
cardiac defect. His metabolic needs are *greater* than those of other kids.
And, he for sure needs the HIND milk, because he's at risk for poor weight
gain.

I'll gracefully bow to the expertise of any current NICU nurse or doc here,
as it's been awhile since I've taken care of really sick kids, and cardiac
stuff was never my forte! But if you just want some general guidelines on
priorities and clinical management strategies for kids with cardiac
defects, I've covered it in chapter 7 of my book.

>The term is
>Persistant Ductus Arteriosis or PDA, a common problem with preterm babies
>where the change from fetal to infant circulation is impaired.
--
Marie Biancuzzo, Perinatal Clinical Nurse Specialist
[log in to unmask]
Resources to simplify breastfeeding management are available at
http://www.wmc-worldwide.com

             ***********************************************
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