From: Gladys Mason, MS, RD, IBCLC Subject: Response to FTT/ Diabetic Mother The problem that you are describing is bigger than you can handle yourself. In addition to seeking advice from your supervising instructor, explain to the parents, one more time, that you are very concerned about their baby. Explain that you are very concerned because it is too sleepy, and looks ill. You will need to confront them with what they are saying verses what they are doing. Let them know that you know they have not kept appointments that they said they did. Tell them that you believe the baby must be seen by the doctor today, and that you believe the baby might need to be hospitalized for observation. Insist that they must get the baby to the doctor-- today. Depending upon the parents' response, you will be required to discuss your concerns with the Child Protection Agency in your state. With the documentation that you have you can make an excellant report of suspected child abuse/neglect. These parents need some parenting services provided to them, in addition to lactation consultation services. A few other points to consider: Large for gestational aged babies (LGA) born to diabetic mothers do have a larger than normal amount of body fluid at birth and will lose a larger than average body weight loss, often are poor eaters, are sleepy babies, often gain weight slower than average, and sometimes need supplemental feedings. The mother needs to have lots of support from her health care providers, including her physician, diabetic educators, nutritionist, and lactation consultant. She needs support from a multidisciplinary team working with her. Good luck. This is a difficult situation.