First of all, anonymous poster, hugs to your perceptions and the work you were able to do.  How sad this must make you feel.  And how horrible for the mom.

I think this is a failure too often seen, but fortunately not always so 
tragically.  Parents, in wanting to insist there is nothing "wrong" with their 
baby, find out that there is something fairly serious going on only when 
things get to an advanced, if not irreversible state.  Or LCs, not wanting to 
alienate parents, or overstep their boundaries of practice, are not strident 
enough or powerful enough to make sure that the infant is seen despite 
mom's wishes.

What a painful job this can sometimes be...how fortunate we are that far 
more often we can make a positive difference, and experience so much joy from our profession.

Chanita, San Francisco
BSc,RN,IBCLC

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From:   Kathleen Bruce[SMTP:[log in to unmask]]
Sent:   Monday, September 07, 1998 8:12 PM
Subject:        anonymous post

This is an anonymous post to LACTNET. The author wishes feedback, but also
confidentiality.

Thanks. Replies to list and to me at [log in to unmask]

Dear friends,
Several months ago I received a counseling call from a woman whose baby was
not nursing. The mother tried exclusively breastfeeding for several days,
but the baby never did latch on at all or would latch on and pull off, no
pacifiers or artificial nipples were used, the baby failed to gain weight
and so the health care provider reviewed latch and recommended the mother
supplement with an SNS. Baby did not feed well with SNS, feedings took a
very long time and were frustrating for mother and baby. Baby paused and
pulled off a lot and again never really latched on good. The baby was
several weeks old when she called me as a last resort. She had been
exclusively bottlefeeding for about 2 weeks, she reported really wanting to
breastfeed, but not feeling like she could continue fighting it. Her
motivation to go to a lot of trouble to "fix" things seemed very low, but
she did call. She was pumping and feeding all of her expressed milk in
thebottle and then supplementing her milk with formula. She reported that the
baby bottle fed very slowly, pausing often.  I suggested that perhaps the
baby had a swallowing problem or an uncoordinated suck, swallow pattern, her
descriptions also suggested that baby was protecting his air way and it made
me wonder about his oxygen saturation during feeds and the possibility of a
cardiac problem. I recommended that she consider seeing a qualified speech
pathologist and also contact her health care provider to evaluate baby's O2
during a feed. She seemed a little irritated that I was suggesting that
there may be a problem with the baby. I followed up with a telephone to the
health care provider as a courtesy and to make sure they understood exactly
what I told the mom, what my concern was and what follow-up was recommended.
I did not hear from the mother again. I heard that she continued pumping,
but abandoned efforts to breastfeed directly.

Last week, this baby died from bacterial meningitis. I can't help but wonder
if his feeding difficulties weren't in some way related to his
susceptibility and/or his death. I have posted this anonymously to maintain
confidentiality, but would appreciate your thoughts. Thanks.


Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
in beautiful Williston, Vermont, USA
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html