Well, the doctor and I talked.  She was very angry that I had given the
parents information that contradicted her covering Peds. They are the
doctors and I'm not.  And it is most inappropriate for parents to be making
decisions to not follow the doctor's orders, as the doctor is responsible
for the health of the baby. I gave my opinion that it is the parents who
are responsible for their children, and that the rest of us are there to
work with them, with our educated expertise.

Also, she was afraid that the other doctors would be hesitant to cover her
breastfeeding patients. "They are all very good doctors, but they aren't as
enthusiastic about breastfeeding as I am." [We're not talking about rooting
for the Green Bay Packers here!] I suggessted that if they were more
knowledgeable they might be more enthusiastic. This doctor is feeding her
second child now.

She also said that they have a group practice of 5 pediatricians who cover
for each other and that they *all* agree on the jaundice treatment that was
carried out last weekend. I enlightened her verbally, assuring her that I
know it is hard for them to keep up on everything, [Of course, much of this
jaundice information is 8-10 years old, and reinforced since.] and loaned
her my Lawrence and Riordan/Auerbach books for 3 days, with the Jaundice
sections marked.  I enouraged her to buy the books for the practice so that
they could be up-to-date on breastfeeding, as feeding and growth are a
major part of an infant's health.

I don't know if the issue is dead yet.  I will pick up my books on
Wednesday, the parents are finding a doctor who is closer to their home,
and I'd like to talk with this doctor further to see if we can work together.

One of the best things to come out of my involvement in this case is that
the parents *dont* think that their baby was in danger. The R/A text has a
great section about the long-term feeling of the parents that they have a
"sick baby." I can't remember what the term is, and I can't look it up
because I don't have my book. :) I'm sure that their confidence in their
own judgement would have been eroded if they had accepted the diagnosis of
"serious condition" when their eyes saw a well-fed, vigorous, alert,
growing little boy, who wasn't yellow.

I know that my being there caused more turbulence than if I hadn't been.
They would have just worried and followed everything exactly. But I hope
that I have started them on the path of taking responsibility for the
well-being of their child that will be with them forever. We all need to
get to that place sometime in order to be advocates for our children as
they grow up.

BTW, why wasn't he yellow when his bili was 14? Only his eyes were slightly
yellow.

Patricia Gima, IBCLC
Milwaukee


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