I have permission from mother to post this and ask questions.  I am working with my friend,  who's baby was born 3 weeks early.  She is currently 6 weeks 2 days old.  She had jaundice that took a good 4 weeks to resolve with baby sleeping in excess of 5 hours at night.  I recomended mom not allow her to sleep longer than 3 hours maximum ever 4 and that she consider expressing and topping of via cup feeding as baby tends to fall asleep quickly at the breast and was having problems voidling.  She was urinating well however was not passing meconium taking 4 day gaps between BMs.  Her weight gain was approximately 5 oz per week.  Low yes but still gaining.  My concern however was the jaundice and had recomended even supplementing with mother's hind milk only due to the jaundice and slow gain.  At her last visit to the ped, the doctor only seemed slightly concerned with her weight gain however he had discovered a slight murmer and sent them to a cardiologist last week.  The only
 instructions were that he wanted her "somewhere in the 9 lb. range" (according to mother who could not remember the actual ounces) by next visit.  The cardiologist discovered VSD (a hole between the chambers of the heart) and a bicuspid aortic valve.  In addition there was fluid around the heart that is being attributed to a virus that seems to be resolving itself.  My thoughts were to continue to recomend hind milk (which mother has yet to try any supplementation in spite of my recomendations, yet agreed to conisder it our last conversation).  And it was recomended I suggest fenugreek as she has started back to work and could use the boost as her "stash" is still very low.  Have I missed anything?  Is there more we can recomend to help lactation wise?  Surgery is not being considered until the baby is 5 years old.  I'm also hoping although somewhat OT, if anyone here knows of any support groups for parents of cardiology patients in the Pittsburgh area...North Hills or further
 north/west.  I would love to be able to present this to her as she has no support system in place yet for her daughters medical condition.  Thanks for any input.  This is a case that has me sitting on my hands reminding myself that I am not the mother.  A lesson learned in boundaries as well as lactation.

Susan Smallwood CLE in PA

		
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