Babies with cardiac malformations generally grow better when breastfed 
rather than bottle fed because they have an easier time maintaining 
blood oxygenation during breastfeeding. This said, the baby may require 
shorter more frequent feeds.

There are subtle signs of cardiac disorders during feeding. Baby's 
respiratory rate will generally increase while he tires, and his 
swallowing may become sloppier. This is because the hypopharynx (the 
area where the airway and foodway cross, the center of the x shape they 
make) is what Dr. Julie Cichero calls a "biological timeshare", only 
food or air can occupy it at any one moment. When milk is there, the 
baby must suppress his breathing long enough to swallow, or he risks 
getting the milk into the airway. When a baby has to work harder to get 
oxygen around his body, he has to breathe faster or harder. This leaves 
less openings in the timeshare schedule for milk to use the hypopharynx, 
or if the milk flows down anyway, the baby will not have enough spaces 
for the breaths he needs, and he may start to breathe even though there 
is still fluid in the airway, like someone whose head is held underwater.

I imagine this baby had some sort of palliative shunt procedure done in 
the hospital, or at least is on prostaglandins to keep his ductus 
arteriosus  open. If he is doing this well without either of the above 
procedures, he probably has a large hole between the ventricles of the 
heart as well. If this is the case, he will need more calories than 
usual to maintain growth. He will require closer followup.

Danger signs include wet breathing sounds after feeding (milk went down 
the wrong pipe), a loud purring sound during breathing (the lungs are 
getting affected by high pressure in their blood vessels), and failure 
to feed. If the work of getting oxygen gets very difficult, the baby may 
not have time for eating, and should be seen by the specialist right away.

Best with helping this mom.
Catherine Watson Genna, IBCLC  NYC

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

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]