Dear Laurie--
The story you relate in this email is terrible.
Thank you for your permission to share it with my colleagues, some of whom
are in your geographical area and will be able to help more than I can. I
am sure that many of them will respond directly to you and guide you to
nearby HCPs who can help.
The hospital is practicing antiquated newborn care, bordering on malpractice
with the potential for harming far more babies. No intelligent, reputable
physician gives a normal full term baby ³a bottle (water) given to verify
that the baby can swallow² and this ³test² could lead to everything from
poor and delayed nursing to aspiration and serious trouble as could the
Alimentum.
The concentrating of the formula at slightly more than the usual rate is
wrong, too. This baby is more than double birth weight at slightly over six
months of age andunless something is starkly wrong with the babyıs
development, the mother should be supported and formula should be
discontinued. Momıs pumping is laudable and she needs continued LC
observation and support as she moves back to exclusive breastfeeding with
appropriate solid foods as a complement to her nursing.
The social worker threatening the mother should lose her job over this case.
You have described normal growth and development. Mom is doing wonderfully
in the face of horrible advice and threats.
Letıs get to work moving these obstacles out of her way.
Please feel free to show this email to the doctors and social worker
involved. They are not acting the babyıs best interests.
Best,
Jay Gordon, MD, FAAP, IBCLC
From: laurie m <[log in to unmask]>
Date: Mon, 17 Jan 2005 19:55:37 -0800 (PST)
To: <[log in to unmask]>
Subject: Looking for guidance, regarding "failure-to-thrive"
I know you are nowhere closeby, but as a doctor with a special interest in
breastfeeding, do you have any info you can offer on what to do next, or
have advice on how I can find someone in the area who may be of assistance?
Background info:
Mother's age at time of birth: 20 years
first pregnancy. delivered at 38 weeks
labor augmented with AROM and Pitocin. had epidural anesthesia.
Baby was born on June 22, 2004.
birthweight was six pounds, five ounces.
breastfeeding started within a few hours of birth, then baby was taken to
the nursery for standard procedures, which in this hospital includes a
bottle (water)given to verify that the baby can swallow. later on baby also
received bottle of glucose water, due to low blood sugar.
Baby did not gain well, and was started on supplemental formula after feeds
at the breast. They tried several different formulas unsuccessfully, and
eventually found that the baby tolerates "Alimentum".
Mother has been told that her breastmilk is inadequate, and that she must
supplement more, along with giving baby more solid foods. She has also been
instructed to concentrate the formula. Instrtuctions are to put three
scoops of powder into teh bottle, and then fill with water up to the five
ounce mark. normal preparations are one scoop of powder to two ounces of
water).
On Thursday, (January 13, 2005), a social worker told the mother that if she
did not stop breastfeeding the baby, and give her the bottle and solids, and
the baby did not gain a "sufficient amount of weight" that they were going
to remove the baby from the home. On Friday, the baby had a doctor's
appointment. The baby weighed thirteen pounds, one ounce.
She has been hospitalized two different times, once for RSV, and most
recently strictly because she was not gaining weight well. She has had
thyroid testing, testing for cf, etc.
Observing the baby, she looks healthy. She smiles, babbles, grasps/plays
with things, laughs etc. Exactly how would one determine that a mother's
milk is inadequate? Is there even anywhere that tests the composition of
breastmilk anymore?
The mother has drastically cut back on breastfeeding, because she fears that
her child will be taken from her. She is double pumping with a medela pump,
and storing this milk, to try to maintain at least a little bit of a supply.
She wants to continue breastfeeding until the baby is at least a year old.
The baby and the mother both enjoy the closeness it brings. She is following
doctor's orders (over) concentrating the baby's formula. If it were up to
her though, she would be using no artificial milk at all. Do you have
***ANY*** suggestions as to what this mother can do, or where she can go
from here? I know this information is not adequate to get the "whole
picture" but it is a start, and you can tell me if there is possibly another
option to try.
ANY info or direction is much appreciated.
Sincerely,
Laurie L. Marcurella
Beaufort, SC 29906
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