On Friday the baby was seen by Dr. D, mom called me after and told me that
Dr. D did not get a chance to see the diaper because she had left it at home
on accident.  He did take a smear from inside the rectum and it was negative
for blood. He also drew blood for labs, she did not know what though.  He
gave her a culture kit and some stool specimen containers and told her to
collect the stool (right from the diaper which as I told you all before Dr.
W said would contaminate it!)  He further told her to begin supplementing
with Alimentum since the baby had not gained any weight in a month.

The parents have family in Florida and they had planned to go help aging
parents with things, mom also needed the help of a supportive family so they
went to Florida Friday night and came back late Monday. I saw Dr. D in the
hall on Tuesday, he also mentioned that "whatever I said to them really
upset them"  But then he said that the baby had looked really pale. He also
said that the labs had been normal, later he mentioned that the CBC had been
normal so I was under the impression that was all he had drawn.  He also
said that they were coming back in this week so he would hopefully be able
to rule out any other problems from the stool cultures.  I went into the
concerns that I had and described for him what I saw.  He said that he
thought it might blood, and he really did not get a good swab in the office,
but since the CBC was alright he was reassured.
   Mom called me later Tuesday and said that they had not been successful
with getting the baby to take much supplement. He would not take a bottle at
all and he screamed when he saw it.  He only wanted to nurse and he was
nursing even more than usual but not fussy as before. She said he seemed
much better this weekend, the stools have slowed in number but had not
changed in color or volume.  She then came into the office so that I could
show her how to supplement at the breast, he had gained 2.4 ounces over the
weekend.

Today, Wednesday, mom took baby back to see Dr. D.  He told her that there
were some elevations in some of the Liver Function Labs and that he needed
more labs drawn to investigate further. Then he saw the stool samples!  He
told her "this baby is sick, we should have looked at this sooner."  He told
her that he was ruling several things out and would go over all of the tests
when the results are in.  He did not tell her what was elevated or what he
was looking for.  She has been able to get him to take about 1/2 an ounce
with almost every feeding using a supplementor and today he had one stool
that actually looked "a little more like it had breastfeeding stool mixed in
it"  Mom is relieved to have her concerns met and that they are doing
something about it. And she is grateful that I encouraged her and her
husband to seek further medical attention.

Another plus...  I felt I needed to inform my director since both doctors
expressed that I had overstepped.  I felt they may make a complaint to her.
She was completely supportive of my actions and recommendations to the
parents. She said that she felt I handled the situation well, as an advocate
for the patient.

I am thinking maybe a bowl of alphabet soup for Dr. W... so that she can eat
her words!  But honestly it is quite enough to know that there really is
something going on,  I did not misjudge the situation and the baby will get
the medical attention he deserves.

Pam Price IBCLC, CBE
Lactation Services Coordinator
Women's Health
Trident Health System
9330 Medical Plaza Drive
Charleston, S.C. 29406
(843) 824-5013 office
(843) 728-9640 pager

> This email and any files transmitted with it may contain PRIVILEGED or
> CONFIDENTIAL information and may be read or used only by the intended
> recipient. If you are not the intended recipient of the email or any of
> its attachments, please be advised that you have received this email in
> error and that any use, dissemination, distribution, forwarding, printing,
> or copying of this email or any attached files is strictly prohibited. If
> you have received this email in error, please immediately purge it and all
> attachments and notify the sender by reply email or contact the sender at
> the number listed.
>

             ***********************************************

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