Thank you to all the answered. The baby did get admitted, and I was able to work with her some more. Mom is basically feeding EBM and ABM via bottle, and the baby has gained weight and doing much better. Mother is hoping to transition back to the breast at some point. If the baby keeps growing well, I suspect she will be successful.
Melissa Senf
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Laurie Wheeler
Sent: Tuesday, August 21, 2012 1:49 PM
To: [log in to unmask]
Subject: failure to thrive/heart defect
This sounds like a very sick baby. First, I would want a pediatrician who is going to be very proactive getting baby evaluated and treated, coordinating the subspecialties, and being bf-friendly, if at all possible. I think waiting 2 wks to be seen is too long!
Then I might do one or more pre/post feed weights to see what amount of milk baby is transferring, which I assume to be very low. Baby's with cardiac defects also can be using more calories to feed, breathe, so that is a factor too.
Therefore, even without the test weights, I would have mom expressing milk as often as she can, and supplementing baby with all ebm (and perhaps abm if needed for low volumes) either by bottle or lactation aid, whichever I assessed to be easiest for baby to take in more milk. I would detail for mom, based on pre/post wts and what she can express, how much to feed the baby and how often. The baby may actually not be able to manage "at the breast feeding" right now. This baby needs calories. I would schedule frequent wt checks and support of course.
While preserving the breastfeeding relationship is certainly extremely important (and I take that to mean "at the breast feeding"), this baby's need for calories seems to take precedence over this "at the moment."
Opinions expressed above are not necessarily those of Baptist.
Laurie Wheeler RN MN IBCLC - Mississippi USA
Baptist 100. Well beyond a century.
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