Kathleen and all,

Studies by Paula Meier and Gene Cranston Anderson,and by B Marino, et al have
demonstrated that feeding at the breast is less stressful to compromised
infants than is bottle-feeding. Marino studied 7 infants with congenital heart
disease and found that the oxygen saturation during breastfeeding was higher
and varied less than during bottle-feeding. None of the infants desaturated
(SaO2<90%) during breastfeeding, but four of the infants desaturated during
bottle feeds. Marino and collegues at Children's Hospital in Boston concluded
that cardiorespiratory was less during breastfeeding.

Dr Ruth Lawrence suggests that the baby with a heart defect be fed on one
breast per feed to increase the intake of hindmilk and to reduce the stress of
switching to the other side. (Meier has found that position change is
stressful to the infant.) The BAB also suggests feeding expressed hindmilk to
increase calorie intake. Some babies with cardiac problems may need extra
calories, but not extra volume, in order to gain weight since their energy
expenditures are greater than that of healthy babies. The hindmilk may be
given by supplementer at the breast, finger-feeding, cup, spoon or dropper to
avoid the bottle.

Hope this helps,
Warmly,
Carol Kelley  LLLL

References:

Lawrence, Ruth A. Breastfeeding: A Guide for the Medical Profession. Mosby
1994 4th ed. p 431-432, 464

Mohrbacher, Nancy and Julie Stock. The Breastfeeding Answer Book. La Leche
League International 1997, revised edition  p296-297

Marino BL, et al. Oxygen saturations during breast and bottle feedings in
infants with congential heart disease. J Pediatr Nurs 1995; 10(6):360-364

Meier P. Bottle-and breast-feeding: effects on transcutaneous oxygen pressure
and temperature in pretrem infants. Nurs Res 1988; 37:38

Meier P, Anderson GC. Responses of small preterm infants to breast- and
bottle-feeding. Matern Child Nurs J 1987; 12(2):97-105