I'm finally catching up on Lactnet.
I saw the brief thread on the baby with heart disease.
I presently have a 3 month old in my practice who has a single ventricle.
He has had one shunt surgery, still a poor feeder.
He tires out at just under ten minutes of feeding
Mom is motivated as BF with first baby didn't go well.
Based on talking to some lactation experts and giving options to mom we
decided:
Breastfeed ad lib with some prefed pumping as tolerated by mom, 2 or 3
bottle feeds a day of Neosure, this is a 22 cal /oz formula with more
micronutriants than added powder ABM to milk would give, and 2cc/kg day of
corn oil.  To make the corn oil taste better mom adds some breast milk fat.
This baby is a poor bottle feeder too and doesn't nurse well at all after
mom pumps even if its just a few minutes of pumping.
Same side twice doesn't work, he's done at ten minutes.
The little guy is still feeding and growing poorly so next step is
nasogastric tube feeds after breastfeeding.
No easy or clear cut way with these little ones as there aren't enough
studies.

Rob

Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
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