Janaki, It is likely that this baby is tiring quickly and therefore having difficulty with feedings. What about getting the mother to rent a good, electric breastpump, then cupfeeding or SNS feeding the hindmilk to encourage better weight gain after nursing? I would continue with breastfeedings for learning and comfort and to keep up the milk supply, but don't allow the baby to tire out. Try to conserve the baby's energy. These babies are typically poor feeders (with bottlefeeding also) and tire easily. They show progressive cyanosis ("blue babies"). It is rare at birth, but about 1/3 show it soon afterwards, another 1/3 during the first year, last 1/3 in the next few years if surgery not done. Watch for circumoral pallor (pale around the mouth) and nailbeds looking bluish. These babies have high hematocrits as the body makes more red blood cells to try to carry more oxygen. Their blood is thick, and they may therefore be at risk of a cerebral vascular accident ("stroke"), so the baby should be kept well-hydrated. They are also at risk for frequent respiratory infections - another good reason to continue breastfeeding. I would be protective of this baby to try to keep away from people with colds or other infections. It has been a while since I have cared for these babies in hospital settings, but these are basic points to keep in mind. The physicians and nurses working with the family should explain plans and procedures specific to this baby's care. They should go to a large university hospital with lots of experience with this heart defect. Most such practices have a social worker to help and support these families. What is hard for parents is learning to negotiate the complexities of the health care system when they are not yet used to this, especially if they are far from home. Other families they meet at the hospital or clinic can often be helpful here. You can help a lot by being a good listener, sounding board, caring and supportive person as the parents face the stress of a baby with a major, long-term heart defect that will require future hospitalizations and surgeries to correct. Anne Altshuler, RN, MS, IBCLC and LLL Leader in Madison, WI