Let me begin by saying that my experience with lasix, digoxin, and weight
gain (or lack thereof) is mostly personal. My oldest child, now 5yo, was
born with AV Canal. In my own uncontrolled study of one, I would notice
that the slowing of weight gain would precede the need to increase the med
doses. Almost all ped cardiology texts state that "poor feeding" is the
first sign of impending congestive heart failure in babies. Or, as our ped
card explained to me, feeding in an infant is like a treadmill test in an
adult. Each time, after he would increase the med doses, there would be an
initial lag while the diuresis took place, then she would start to gain
again, once her cardiac function improved. All that having been said, the
card did also tell me that both lasix and digoxin seem to have appetite
suppressant effects in babies, though not necessarily in adults.
Beckt Saenz, MD, IBCLC
mother of Janette, 5yo, who now takes gymnastics lessons!
At 09:57 AM 06/13/2001 -0400, you wrote:
>I am at work at the health dept and need some references. all of mine are
>on the computer at home. Remember my baby with the heart problems that had
>surgery at Hersey in Jan? She is a slow gainer-34 oz in 15 weeks and none
>in the past two weeks. The MD here
>( not the hospital where I work at on weekends, but the one in our
>town-large teaching facility with a med school) admitted the baby last
>night to the hospital for supplementation. He ordered the mom to wean (
>she refused) and ordered his nurse to give the baby a bottle in the
>office! This baby wouldn't take a bottle-has a bad gag reflex. Mom's milk
>supply is great.
>I spent over 5 hrs last night with them. The baby nursed 4 times very well
>during this time. we did a pre and post feed weight at the first feeding-
>I don't know if she gained any because the nurse wasn't sure of the exact
>weight the first time. The baby then peed and lost 2 oz. As I was talking
>with the dad, I asked about meds. The MD here doubled the dose of lasix
>the baby was prescribed by the ped cardiologist in Penn. He also increased
>the digoxin. The dad questioned whether the increased lasix could be the
>cause of the slow weight
>( she hasn't gained any over the past 2 weeks and the meds were doubled 4
>weeks ago). The resident told the dad he didn't know what he was talking
>about and there couldn't be any relation between lasix and slow weight gain.
>The parents don't want any cow's milk products given to the baby due to
>the dad having type 1 diabetes. The residents ( who waited until I left at
>midnight to come in to talk to the couple) told the dad that what he was
>saying about an increased risk of diabetes relating to cow's milk intake
>was "bunk" and not any studies have proved that. I need a list of
>references for that if anyone could email those to me so I can fax those
>to the couple.
>I suggested doing a creamatocrit-even took in Lawrences book to share with
>them. This baby is very alert, strong and happy. She could even eat off
>cooled cream off the top of expressed breast milk with a spoon.( one of my
>suggestions). We suggested also using a SNS instead of a feeding tube. No
>luck. Then when the nurse put in the feeding tube, she didn't get it
>inserted the first time, took it out, laid it on the bed, wiped her face,
>and then reinserted it. Then they didn't use the feeding tube at all last
>night.
>One of the nurses also told me that Human Milk Fortifier was from Breast
>milk! I suggested she read the ingredients on the label.
>This family is fighting for this baby and I hate that I couldn't be there
>today helping to run intervention.
>If anyone can sent a list of diabetes references, I would greatly
>appreciate it. Also any help with how to deal with uneducated, uninformed,
>unwilling to listen MD's. Also any info on lasix and weight.
>I was so upset last night, I threw up when I left.
>And this doesn't even begin to discuss the insensitivity of the nurses
>stopping while placing the feeding tube to order their dinner, not washing
>their hands, not introducing themselves or talking with the parents, and
>the lack of meals for the mother. Or that I had to ask for a brast pump,
>which was then brought in nasty and I had to ask the nurse to please clean it.
>
>Since this isn't health dept related, I need to try to do some work here.
>Thanks.
>Barbara Whitehead, IBCLC
>Eastern NC
>
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