Many times in this situation, I find that I cannot get the baby to gain weight in a reasonable amount of time. If given a choice to eat or breath, the baby will choose breathing. A baby with this severe of a heart defect burns almost as many calories feeding as he/she is taking in...so the result is super slow weight gain. Usually, what you are dealing with in these situations is getting the baby to gain enough weight to be strong enough for corrective surgery. The surgery is what is needed to make the feedings more effective. What I suggest is to fortify the supplemented breastmilk with a concentrated formula to boost the amount of calories the baby is getting. When the baby is term, I use any standard formula, or even a predigested one. If it is a preterm, a preterm fortifier is used. If you can boost the calories by 4, 6, 8 calories/oz in the expressed supplemented breastmilk, you will see better weight gain for this baby. The sooner the surgery, the sooner the baby will be able to just breastfeed and thrive (and no more formula!). A pediatric dietitian would be able to help you figure the recipe for this. As an aside, have you heard that a new company (Prolacta) is beginning to process fortifier made from human milk? As soon as this comes out, I will use this when extra calories are needed. You can check out their website at www.prolacta.com. They are doing some exciting things. Ginger Carney, RD, LDN, IBCLC, RLC Le Bonheur Children's Medical Center Memphis, TN *************************************************************** *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html