Managing Pediatric Concerns: Enlarged Left Ventricle and Feeding Issues

Enlargement of the left lateral ventricle and feeding intolerance issues?

Hello, Doctor.
I apologize for coming to you again, but I have three questions I would like to ask:
1) Previously, I made an appointment for my baby in mid-June (when the baby was two months old) for a follow-up on "left ventricular dilation" and "patent foramen ovale." Due to the pandemic, the hospital canceled our appointment.
Given the recent pandemic situation, is it appropriate to reschedule for a follow-up? I am uncertain about the implications of ventricular dilation; is it necessary to follow up on time? (The attending physician mentioned at one month that the foramen ovale might have closed, so we were advised to follow up on the ventricles as well.)
2) By late June, when the baby was nearly three months old, he weighed about 6.45 kg (with clothes and diaper).
He is fed formula milk six times a day, with 170 ml per feeding.
Initially, he drank well, but starting in late June, he showed signs of milk aversion, drinking at least 100 ml for at least three meals a day, although his activity level remained high.
Recently, he has improved, drinking 130-140 ml per meal, and sometimes when very hungry, he can drink up to 190 ml, making up for some of the lost intake, and he still has plenty of energy.
Should I let this situation unfold naturally and continue to observe, or should I consider feeding smaller amounts more frequently? I previously asked a nurse, and she mentioned that formula should be fed every 3-4 hours.
I am concerned whether shortening the feeding intervals would put too much strain on the baby's gastrointestinal system.
3) The baby is currently three months old and can sleep through the night, but during the day, he sometimes takes longer naps when he plays too hard.
I read in a healthcare article that during a milk aversion period, it is recommended to feed on schedule.
However, if the baby is still sleeping, is it appropriate to wake him up for feeding? Or would you recommend waiting until he wakes up to feed him and then shortening the intervals for subsequent feedings?
Thank you, Doctor, for taking the time to read this.
I appreciate your guidance.
Thank you.

Xinshou Ma, 20~29 year old female. Ask Date: 2021/07/12

Dr. Xiao Kaiwen reply Pediatrics

1.
It is still important to follow the physician's advice and not to delay examinations too much.

2.
If weight gain is normal and activity levels are appropriate during the natural period of milk aversion, it is best to observe without forcing the issue, as this may inadvertently prolong the aversion period.
Feeding should primarily be based on the infant's needs rather than adhering to a strict schedule.

3.
If weight gain and urine output are normal, there is no need to feed the infant while they are deeply asleep; wait until they wake up to feed.
Infants will typically drink more to compensate when they are awake.
The decision to shorten the intervals between feedings should also be based on the infant's own needs.

Reply Date: 2021/07/12

More Info

When it comes to managing pediatric concerns, particularly regarding an enlarged left ventricle and feeding issues in infants, it’s essential to approach the situation with a comprehensive understanding of both the medical implications and practical feeding strategies.
1. Follow-Up for Enlarged Left Ventricle and Ventricular Width: Given the context of your baby’s condition, it is crucial to maintain regular follow-ups, especially for conditions like "left ventricular enlargement" and "ventricular widening." These conditions can have varying implications depending on the underlying causes and the overall health of the child. The fact that your healthcare provider previously mentioned the potential closure of the foramen ovale (the oval opening in the heart that usually closes after birth) is a positive sign, but it does not eliminate the need for monitoring. With the ongoing pandemic, many healthcare facilities have adapted their protocols, and it is advisable to contact your pediatrician's office to discuss the current situation and the necessity of rescheduling the follow-up appointment. Regular monitoring can help ensure that any changes in your baby's condition are addressed promptly.

2. Feeding Concerns and Patterns: It is not uncommon for infants to experience fluctuations in their feeding habits, especially around the three-month mark. The fact that your baby has shown signs of "feeding aversion" (or "nursing strike") is something many parents encounter. It’s important to remember that infants can have varying appetites due to growth spurts, developmental changes, or even minor illnesses. If your baby is active and gaining weight appropriately, it may be reasonable to adopt a "watchful waiting" approach. However, if you notice a consistent decrease in intake, you might consider implementing smaller, more frequent feedings. This could help ensure that your baby is getting enough nutrition without overwhelming their digestive system. Generally, formula-fed infants are typically fed every 3-4 hours, but if your baby is showing signs of hunger sooner, responding to those cues is essential.
3. Feeding During Sleep: Regarding feeding schedules, it’s generally advisable to allow your baby to wake naturally for feedings rather than waking them up, especially if they are sleeping soundly. Sleep is crucial for an infant's growth and development, and interrupting sleep can lead to increased fussiness and feeding aversion. If your baby sleeps through a scheduled feeding time, it’s usually best to let them sleep and offer the next feeding when they wake up. You can adjust the timing of subsequent feedings to ensure they receive adequate nutrition throughout the day.
In summary, maintaining regular follow-ups for your baby's heart condition is vital, and any changes in feeding patterns should be approached with flexibility. It’s essential to observe your baby’s cues and adjust feeding strategies accordingly. If you have ongoing concerns about your baby's feeding habits or health, do not hesitate to reach out to your pediatrician for personalized advice and support. They can provide guidance tailored to your baby's specific needs and circumstances.

Similar Q&A

Understanding Enlarged Lateral Ventricles in Preterm Infants: Key Concerns

I would like to consult a physician regarding my child, who was born prematurely at 28 weeks with a birth weight of only 840 grams. Approximately two weeks after birth, he experienced grade 3 intraventricular hemorrhage, but later stabilized and gradually absorbed the blood. Afte...

Dr. Xiao Kaiwen reply Pediatrics
Piracetam is a relatively mild medication, and long-term use does not show significant side effects. Please follow your physician's advice and do not discontinue the medication without consultation. Currently, the development and his corrective age do not show significant de...

Understanding Heart Defects in Children: Growth and Treatment Insights

Hello Dr. Wang, My daughter is one year and seven months old, currently weighing around 8.5 to 9 kilograms. She was diagnosed with a heart defect at birth, which requires her to have check-ups every six months. After our visit to the hospital yesterday, I began to have many ques...

Dr. Wang Jiayi reply Pediatrics
Hello, Ah He: It seems that you care deeply for your child. Your questions should be answered by a trusted pediatric cardiologist who can provide regular follow-up. Different opinions from various doctors may only add to your concerns. There are some good reference materials avai...

Nutritional Guidance for Infants with Congenital Heart Disease

Hello, my child has just turned 6 months old and is suffering from congenital heart disease. She has a low milk intake and is gaining weight very slowly. Currently, she is on medications such as digoxin, diuretics, and anticoagulants to manage her condition. Surgery is planned wh...

Dr. Liu Qiaoyun reply Nutrition
Hello, generally, a typical four-month-old child weighs about twice their birth weight, and by one year old, they weigh about three times their birth weight. If your baby was born weighing around 2600-2700 grams, they would be approximately 8 kilograms by their first birthday. Si...

Understanding Pediatric Heart Murmurs: Care and Concerns

Hello, my child has a heart murmur and has been evaluated, which was determined to be a functional murmur (tricuspid regurgitation and pulmonary valve insufficiency) with significant blood flow regurgitation. What precautions and care should I take, and is this life-threatening?

Dr. Zhou Zuyou reply Pediatrics
Dear Parents, Functional heart murmurs generally refer to minor structural abnormalities of the heart that do not significantly affect its function. Mild tricuspid regurgitation and pulmonary valve insufficiency are not life-threatening. However, if the regurgitation leads to si...