Extra calories?

[Tricia4257]

My grandaughter was born at 36 weeks gestation and it was discovered that she has a pda, pfo and a stenotic pulomonary valve.  She also has a pelvic kidney  (she is urinating fine)   With the heart murmurs she has no signs of cyanosis.  I do notice that when she lies flat she seems more fussy, like she is have some reflux.  When she lies at an angle she does not seem as fussy.  My question is this:  Does she need extra calories because of the murmurs?  According to the hospital, when she left she weighed 6' 9" on discharge and her birth weight was 6' 10".  Now unless the hospital made a mistake, when the baby went for her cardiology appt last week, her weight was 6' 6".  So that is why I am concerned for her.  Thanks for the answer in advance.  I am trying to figure out how to advise the parents on what to do.   Tricia

[Marie M Gleason, M.D.]

All children are born with a PDA (patent ductus arteriosus) and PFO (patent foramen ovale).  The timeframe for closure of these is very variable. The PFO should not cause any extra work for the heart.  The PDA could if it was large, but generally small to moderate PDA's do not result in failure to thrive that would require extra calories. Pulmonary valve stenosis of any degree is also not usually associated with a requirement for increased calories.  However, some children with valvar pulmonary stenosis are small.  If the child's growth is not ideal, then please have the family sort out what is the size and severity of the cardiac defects, and make sure that the child's intake of calories is at least the minimum required for growth.

[Tricia4257]

Thanks for answering that question.  I used to work at a children's rehab center as the nurse case manager and of course my mind wonders to all kinds of bad things.  You did calm my fears and I really appreciate that..  Tricia