I had a terrible and heartbreaking situation at work last week.  I have debated posting on it and finally decided to avail myself of the wisdom of all of you.

A term, 8lb 3oz infant with 8 and 9 apgars was born by unassisted (no vacuum or forceps) NSD to a G2/P0 mother.  Infant was stable without post birth sequele and was nursing at the mother's breast at one hour post birth.  15 minutes later mother calls nurse's station to report that infant is too sleepy to nurse at the other breast and could she please have some assistance placing infant in the bassinet.  15 minutes after that the nurse enters the patient's room to find, not a sleeping infant but one who is apnic and pulse less.  Full resuscitation was instituted with a post resuscitation course of seizures and eventual unresponsiveness.  The infant was transferred to a tertiary center with pupils fixed and dilated.  Yesterday the baby was taken off life support.  Parents have refused autopsy.

The speculation is that this mother suffocated her infant at the breast (with, as you can imagine, all the resulting calls for changes in allowing early feedings at the breast).  Is this possible?  It has been my experience that an infant who cannot breath at the breast pulls his head back.  Or could mother have missed these cues?  

Thanks for listening,

Stacy Miller-Leonard RN,MS,IBCLC

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