Janaki:

    In all cases of caloric intake, the body much choose where to use thos
calories.. they are not infinite in number... when one is sick the caloric
intake goes to fight the illnes...and usually there is no weight gain,
despite the intake...if one uses the calories to do strenuoius exercise,
there will not be wieght gain. interestingly there is usually either gain in
lenght or gain in bredth... the calories can not be in two places at once...
though they can contibute to two places at once there will be less for
each.... THEREFOR, if this baby has heart defects as you describe that muscle
is having to work "excessively" hard to perform its job... this extra work
requires extra calories...

    One approach often taken is to alter the feed so that there is a greater
concentration of hind milk... she can pump and let it rise, skim and feed,
... if this infant is nursing well as you describe, have her pump the initial
formilk so the feed is a higher fat content... let her put the fore milk
aside....

                      Patricia