Denise Parker,
I've learned from experience and Linda Kutner's experience that poor feeding
is a big "red flag" for cardiac or other serious problems. Her rule is any
sudden feeding problem, or two bad feeds in a row after decent BF is
established, is a cause for major concern. I agree. If once good latch is
achieved, it should continue to improve during the feed and from then on. If
it doesn't, get help fast.

I'm glad this baby was seen by a cardiologist - underlines our philosophy of
"team approach." How does this baby do with a cup?  IMPO, (in my professional
opinion), cups are less stressful than sucking objects to obtain calories in
compromised babies. The feeder should be very, very respectful and gentle and
not overwhelm this baby. Very small feeds with lots of rest periods may work.
A soft carrier holding the baby upright against the chest, kangaroo-style,
will also relieve stress and help preserve this baby's energy. And the skin
contact will feel good to all concerned. Mom's gonna need the pump for a
while to maintain supply - sounds like this baby's too weak to do it on her
own. (girl baby? you didn't say.) She should sleep with the baby, too,
because apnea might be a problem and co-sleeping is protective to the baby -
see McKenna's research.

 Nice work for hanging in with this mom and baby!

Linda Smith, Dayton OH