I am just learning about the health system here, but I have been impressed
with what is available IF moms reach out - however, there are many reasons
why they don't  - undocumented (fear of being deported), drug use, 
frightened of Child Protective Services, depressed ( I suspect this mom
suffered from this), etc.

Many medical offices do NOT find out why an appointment has been missed or
try to reschedule it.  We are trying very hard to get agencies to agree to
request a visit by a Public Health Nurse when this happens, but many
doctors don't even know they exist.  A depressed/overwhelmed mom CAN miss
the signs of a baby in trouble (they see them all day every day and don't
realize there is jaundice, or weight loss - OR weight gain as I just made a
home visit on a baby who was being terribly OVERFED - breast + bottle).

Other family members may say something - or they might not, for fear of
"upsetting" the mom or "hurting her feelings".  Reminds me of the mom I saw
on a Friday PM - experienced bf mom - but baby was tongue-sucking and
losing weight, getting jaundiced, etc.  Only because of our visit was there
appropriate intervention.  I fear if we had not come, the baby would have
been in real trouble.  After all, this mom "knew" how to breastfeed, had
two other very healthy babies, etc....


Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
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