Regarding the baby who isn't getting enough to eat, I think you have to be
very careful about jumping on the Munchausen's by Proxy bandwagon! This is a
very serious accusation. I have worked with hundreds of slow weight gain
babies and have seen over and over that mothers (and fathers) are absolutely
unable to see how bad their kids look.  I worked with an LLL Leader whose
baby was at birthweight at 6 weeks and we were begging her to feed the baby.
She got some donated human milk and used it to supplement very sparingly.
The doctor was on the phone with me daily trying to figure out what to do to
convince this mother to feed her baby, she was a vegetarian and would only
supplement with milk donated from vegetarian mothers (cow's milk protein can
get through into human milk, she would say), then she agreed to accept other
donated milk and finally agreed to use formula. Her baby had a high arched
palate and sucked her nipple up and nursed totally ineffectively. Her
physician and I agonized about calling DHS if she didn't start feeding her
baby.  She never perceived nor understood our concerns about the baby.  Her
denial was so strong that we couldn't get through.  We were very irritated
with her and to this day, she feels that we were disappointed that she
wasn't successful breastfeeding, she still won't acknowlegde the danger her
baby was in and that her refusal to feed her baby was the source of our
irritation. The mother will still also say that the doctor was not concerned
about the baby's status, but I know she was because she was on the phone
with me every day.  I worked with an RN whose mother was an LLL Leader- same
story- "just needed to nurse more..." more than 24 hours a day????? And a
couple of MDs, mom and dad were both family docs, baby was hospitalized with
serious dehydration, below birthweight at 4 weeks and then they decided to
give up breastfeeding because the stress of hospitalization reduced mom's
milk supply????? They just don't see it, just don't accept the concern of
health care providers, just don't want to admit that their baby is starving,
the defense mechanism is incredibly strong.  I used the Medela scale this
week to show a mother how little her baby was getting (<1 ounce in 30
minutes) and why she was getting dehydrated- baby with Down's syndrome,
hospitalized with dehydration once already! Mom said doctors weren't
concerned that baby was sleeping 12 hours at night, and she was doing fine
with breastfeeding. Guess what the doctors said????? This is so common with
slow weight gain babies.  You have to break through the denial and give a
mother concrete guidelines for supplementation. Keeping a written log and
doing test weighs can be very helpful. You must be very direct in stating
babies needs and interventions.  These mothers will also report adequate wet
diapers and then have a baby like the one this week with a quarter size
concentrated strong smelling urine spot. (six wet diapers a day!) Or poop- a
stain at every diaper change. I don't think this is so intentional of the
mother as it is denial. In any event- it needs close follow up and
observation.  Good luck, Cathy Liles