From: Gladys Mason, MS, RD, IBCLC
Subject: Response to FTT/ Diabetic Mother
The problem that you are describing is bigger than you can handle
yourself. In addition to seeking advice from your supervising
instructor, explain to the parents, one more time, that you are very
concerned about their baby. Explain that you are very concerned
because it is too sleepy, and looks ill. You will need to confront
them with what they are saying verses what they are doing. Let them
know that you know they have not kept appointments that they said they
did. Tell them that you believe the baby must be seen by the doctor
today, and that you believe the baby might need to be hospitalized for
observation. Insist that they must get the baby to the doctor--
today. Depending upon the parents' response, you will be required to
discuss your concerns with the Child Protection Agency in your state.
With the documentation that you have you can make an excellant report
of suspected child abuse/neglect. These parents need some parenting
services provided to them, in addition to lactation consultation
services.
A few other points to consider: Large for gestational aged babies
(LGA) born to diabetic mothers do have a larger than normal amount of
body fluid at birth and will lose a larger than average body weight
loss, often are poor eaters, are sleepy babies, often gain weight
slower than average, and sometimes need supplemental feedings. The
mother needs to have lots of support from her health care providers,
including her physician, diabetic educators, nutritionist, and
lactation consultant. She needs support from a multidisciplinary team
working with her.
Good luck. This is a difficult situation.
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