Esther Reich wrote: 

About a friend in Arlington, TX (Dallas/Fort Worth area) who gave birth to conjoined 
twins mid-October, I believe 6 wks prematurely. One twin did not survive. 
The one who did survive received his brother's liver, loves to breast feed (smart boy!) and 
does not like to drink from the bottle. There is an issue of weight gain. 

Before going into any invasive procedures or pushing the bottle on the baby, I have a couple of thoughts: 

* Knowing the birth weight is important but also difficult to know since they were conjoined. What would be helpful is to know the weight after the separation form the other twin and start from there, although it might be skewed if the baby was on large amounts of IV fluids to prepare for surgery and post-surgery. 

* I would first try pre-and post-weights with one or more breastfeedings to get a good sense of baby's intake at breast and proceed from there. 

The more information, the better equipped the mother and any LC she works with can be when determining a) is there a problem and b) what makes the most sense for correcting this problem. 

CIndy Garrison BS IBCLC 
practicing in Pittsburgh, PA 


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