to Fiona: re baby with VSD: You might suggest that the mother hold her baby upright after feeds. Sometimes the distended stomach pushing up against the diaphragm can cause problems in babies with cardiac defects. However as you suggested, the slow weight gain is probably partly due to the heart problem. My suggestion would be short frequent feeds , and supplementing at breast with EBM if possible or ABM if necessary. Some of these babies gain remarkably well after surgery. Eileen Shea