I know what you mean Carmela and I have had this situation a number of times too. I am reminded that nearly every baby with an abnormality has a feeding problem but not every feeding problem is an abnormality.
I keep thinking I would like to share a presentation with my colleagues titled "What lies Beneath". Perhaps one day I will get around to that.
2 years ago I stumbled across 3 babies with abnormalities, one of which was life threatening. In that instance the parents were grateful I called a paediatrician immediately. other less urgent situations I found harder to handle.
I get around this now by gaining consent at the beginning of the consultation to contact their primary practitioner.
Karen Palmer
RM, IBCLC
NZ
Sent from my iPad
> On 9/11/2015, at 6:14 am, Carmela Baeza <[log in to unmask]> wrote:
>
> Hi all,
>
> I´d like your experience on this one...
>
> Sometimes (fortunately, very infrequently) a mother will come to the clinic
> with breastfeeding problems, and as I look at the baby I´ll immediately
> think "There´s something I don´t like about this baby". It won´t be
> anything spectacular, just baby´s skin color a bit off (not jaundice, just
> something about the tone), something about his body posture, something
> about the shape of his face or head, something about his features... As if,
> *if* these signs were more important, he would have a syndrome of some
> kind. But they are only small things that come to my attention simply
> because I see so many "normal" babies.
> Obviously this baby has been seen by at least one pediatrician at hospital
> discharge, more times if the baby is older than a week.
>
> My dilemma here is, do I tell the mother anything? If yes, what? and how?
>
> I´ve faced this situation a few times. The first time, I told the mother
> gently about my impressions. She of course was worried and went to the ped,
> who agreed with me (but hadn´t done anything before), and the baby got all
> sorts of tests (genetic, bloodwork, gut...) for a period of several months,
> and nothing came of it. So the poor child suffered tons of things and the
> parents months of anguish for nothing...
>
> Second baby I told the parents nothing but I had them come in frequently to
> check weight and latch so I could keep an aye on him. Turns out he had a
> rare malabsortion syndrome which was diagnosed a month later. Baby had FTT
> despite mother´s great milk supply and his good sucking skills. So no harm
> came of my not telling the parents about those little tiny signs, but maybe
> if I had he would have been diagnosed sooner or parents would have been
> ready.
>
> Neither option, the telling and the not telling, felt right to me!
>
> So how do you handle these situations? How do you say to the parents "look,
> there is something about your baby that seems to be off, but its just my
> impression" ?
>
>
> Thnks,
> Kika
>
>
> --
> Dra. Carmela Baeza
> Médico de Familia
> Consultora Certificada en Lactancia Materna IBCLC
> www.centroraices.com
> http://www.facebook.com/Consulta.Lactancia.Raices
> <http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>
>
> Autora de "Amar con los Brazos Abiertos"
> http://www.amazon.es/Amar-con-los-brazos-abiertos/dp/8426904688/ref=sr_1_1?s=books&ie=UTF8&qid=1420813499&sr=1-1&keywords=amar+con+los+brazos+abiertos
> <http://www.ediciones-encuentro.es/libro/amar-con-los-brazos-abiertos.html>
>
> Comprometida con el Derecho a Vivir
> http://derechoavivir.org
>
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