Dear Lu,
I appreciate your added info on your knowledge of this case.  I was not
aware you had worked with this mother.  She did mention working with  my old
friend, Lila Allman, whose skills I have ample respect for.  I do feel
somewhat puzzled that you feel defensive about this case.  I've never
suggested the case was mismanaged -- just complex.  In fact, the early
initiation of pumping, and all the advice to do skin-to-skin were quite
appropriate.  None of the interventions with regard to the deep suctioning
were inappropriate -- all were clearly needed to get the baby out of danger.
But like all interventions, they create cascades of events that then have to
be tended to.  Many issues such as the broken clavicle or un-dx heart
defects (for example) aren't always discovered immed.  That doesn't mean
anyone was negligent.  There is
only so much that can be done in a hospt. stay.  But just because it was
missed doesn't mean it didn't hurt.  The baby is still clearly in pain
when touched, so much so the mother holds her gingerly and is cautious about
placing her in some positions.

What interests me is the potential for learning this complex case gives
other LCs.  That is why I described it.  Not, certainly, to embarrass
anyone.  I will post this publically to make sure that there is no one else
who thinks my desire to share this is anything but an attempt to do what
Lactnet is intended to foster -- advance clinical skills by sharing ideas
about cases.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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