I thought I would share with my LactNet friends some excerpts from an
exchange I had yesterday with someone who sent me e-mail (after reading some
things on my Web page) and asked for advice.  She wrote:

"I read with interest one of your articles about frequent breastfeeding.
I have a 5 week old baby whom I have breastfed fully for 4 weeks, hourly
- only for find that he was undernourished after one month.  He looked
scrawny and did not even regain his original birth weight."

I told her I couldn't *really* help over e-mail (turns out she is in
Singapore) and that I wasn't an IBCLC, which is what she probably needed,
but I did provide some general thoughts about frequent nursing, renting a
good pump and pumping and giving the hind milk, more frequent night nursing,
checking for a bubble palate or otherwise ineffective suck, and encouraged
her to follow her doctor's advice to give soy formula to make sure the baby
was getting enough to eat, to keep his strength up and put on some weight.
And I told her to find a local IBCLC.  Then I wrote the following:

"Final thought, which I *truly* hesitate to mention........minor heart
defects can manifest as ineffective sucking and difficulties with
nursing. If a child has a heart defect, they are usually somewhat weak, have
an ineffective suck, and nursing tires them out, so they nurse for a while,
then stop when it becomes more difficult right as they are tiring. They
also have poor weight gain, as it takes all the energy they are consuming to
keep their inefficient heart working overtime.  You might want to ask the
doctor, at your next visit, to carefully check out the baby's heart beat for
any signs of a minor problem.  Again, as with the bubble palate, sometimes
these conditions go undiagnosed in bottle-fed babies for years, and are only
picked up in infancy when a baby is breastfeeding and having
difficulties."

Today she wrote me back and told me she was in Singapore, said she would try
to find an IBCLC, and then wrote:

"It might interest you to know that my husband was also born with a weak
heart ... I'll get the pediatrician to check it out when we visit her on
Monday."

I have my friendship with Barbara Wilson-Clay to thank for alerting me to
this possibility.  I'm *so glad* I didn't just write this woman back and
tell her I couldn't help her.  And I'm also glad I overcame my reluctance to
mention the heart defect problem.  I'll let you all know how this turns out.....

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Katherine A. Dettwyler, Ph.D.                         email: [log in to unmask]
Anthropology Department                               phone: (409) 845-5256
Texas A&M University                                    fax: (409) 845-4070
College Station, TX  77843-4352