I am at work at the health dept and need some references. all of mine are on the computer at home. Remember my baby with the heart problems that had surgery at Hersey in Jan? She is a slow gainer-34 oz in 15 weeks and none in the past two weeks. The MD here
( not the hospital where I work at on weekends, but the one in our town-large teaching facility with a med school) admitted the baby last night to the hospital for supplementation. He ordered the mom to wean ( she refused) and ordered his nurse to give the baby a bottle in the office! This baby wouldn't take a bottle-has a bad gag reflex. Mom's milk supply is great.
I spent over 5 hrs last night with them. The baby nursed 4 times very well during this time. we did a pre and post feed weight at the first feeding- I don't know if she gained any because the nurse wasn't sure of the exact weight the first time. The baby then peed and lost 2 oz. As I was talking with the dad, I asked about meds. The MD here doubled the dose of lasix the baby was prescribed by the ped cardiologist in Penn. He also increased the digoxin. The dad questioned whether the increased lasix could be the cause of the slow weight
( she hasn't gained any over the past 2 weeks and the meds were doubled 4 weeks ago). The resident told the dad he didn't know what he was talking about and there couldn't be any relation between lasix and slow weight gain.
The parents don't want any cow's milk products given to the baby due to the dad having type 1 diabetes. The residents ( who waited until I left at midnight to come in to talk to the couple) told the dad that what he was saying about an increased risk of diabetes relating to cow's milk intake was "bunk" and not any studies have proved that. I need a list of references for that if anyone could email those to me so I can fax those to the couple.
I suggested doing a creamatocrit-even took in Lawrences book to share with them. This baby is very alert, strong and happy. She could even eat off cooled cream off the top of expressed breast milk with a spoon.( one of my suggestions). We suggested also using a SNS instead of a feeding tube. No luck. Then when the nurse put in the feeding tube, she didn't get it inserted the first time, took it out, laid it on the bed, wiped her face, and then reinserted it. Then they didn't use the feeding tube at all last night.
One of the nurses also told me that Human Milk Fortifier was from Breast milk! I suggested she read the ingredients on the label.
This family is fighting for this baby and I hate that I couldn't be there today helping to run intervention.
If anyone can sent a list of diabetes references, I would greatly appreciate it. Also any help with how to deal with uneducated, uninformed, unwilling to listen MD's. Also any info on lasix and weight.
I was so upset last night, I threw up when I left.
And this doesn't even begin to discuss the insensitivity of the nurses stopping while placing the feeding tube to order their dinner, not washing their hands, not introducing themselves or talking with the parents, and the lack of meals for the mother. Or that I had to ask for a brast pump, which was then brought in nasty and I had to ask the nurse to please clean it.
Since this isn't health dept related, I need to try to do some work here.
Thanks.
Barbara Whitehead, IBCLC
Eastern NC
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