A few months ago I made only the second ever Child Welfare Service report on a mother and baby. With infant weight loss approaching 20%, the mother not following through on the feeding and documentation plan that she agreed to, her expressed resistance to supplementation with any other milk while insisting that she could not pump more, and then cancelling baby's appointment with the pediatrician as well as follow-up with another LC (was not my client initially), I became extremely concerned and conferred with superiors, who directed me to make the call. On the Friday before, I had faxed a carefully detailed report to the pediatricians office and also called ahead to ask that someone would read it ASAP. On Monday, when we learned that baby would not be seen by the ped (or anyone else) before Friday, I called the peds office again to see if they had read my report and to urge them to get the baby in sooner; I also wanted to give them a heads up that I had been directed to report the situation to CWS. I asked to speak to a doctor, a nurse, an office manager, but instead was routed to a medical assistant, who did not seem to grasp the gravity of the situation. After this I made the call.

A week or so later, the mother contacted the initial LC (who was back from vacation) and shared that the pediatrician's office "told her that Lisa had threatened to contact CWS" if she didn't come to our appointment. There were other similar reported quotes in which I was named to the mother by someone in the pediatric office. I highly suspect that the medical assistant felt threatened and misconveyed the conversation.

I initially sat down and wrote a vent letter to the [non-responsive] pediatrician involved to lay out what happened and express my dismay/frustration at how this all went down, especially the violation of my privacy as a reporter doing my mandated duty (do I have such a right? I don't know).  I sat on this letter but now there are new developments and I feel like something needs to be said with this ped office. They historically have declined past requests to meet and talk about various issues.

This is a synopsis and there are a number of details that I have not included. The mother had been content to attend multiple LC appointments but did not show appropriate concern that her baby was continuing to lose weight through the first month (not just days) an issue that in itself raises questions. The pediatrician was either ignorant of the facts or disbelieving that a problem existed . This is a very sticky situation, potentially inflammatory, and I would welcome wisdom from other experienced people.

Lisa Marasco, MA, IBCLC, FILCA

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