On 24/2/04 12:49 PM, "Automatic digest processor"
<[log in to unmask]> wrote:

> 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?

This seems to me a scurrilous assumption and very disappointing that health
professionals would perpetrate such a belief, that could be so damaging to
the mother's well being. I have never seen (or heard of) an otherwise
healthy baby "suffocate at the breast". However babies who have severe
illness or anomalies (and are sometimes apparently healthy at birth)  will
become compromised and exhibit symptoms (or arrest) at the first times of
exertion (which is most commonly during breastfeeding)

I have had the sad experience of two babies dying at the breast in this way
in the past few years.

The first was apparently healthy at birth, consultant paed present with full
paed check at this time. Nothing picked up as abnormal. Breastfed OK. At
approx 24 hours during the 3rd breastfeed, baby turned cyanotic at the
breast (midwife present during feed) was immediately resuscitated (nursery
20 paces down the hall) but died. Autopsy revealed severe cardiac anomalies.

The second was not as easily explained. I assisted the mother's labour and
the birth of the baby (vacuum extraction). The baby had good apgars (9:10).
No maternal or neonatal risk factors present. Paed check normal. Great
breastfeed within the first hour. I returned on my next shift to find the
baby had died in the night. The baby had been wakened for a feed as she had
not demanded after 8 hours from the first feed. (In babies without risk
factors it is our policy to encourage them to feed if not demanding within
this time). She began the feed in the presence of the midwife but
deteriorated quickly at the breast under the midwifes observation. A paed
was present in the nursery (it was 2am) as he had just attended an emergency
C/section and although the baby still had a heart rate (80-90) she was
practically apnoeic. Even though resuscitation was begun before actual
arrest occurred she still died during resuscitation. An autopsy and
extensive genetic testing revealed "no known cause". The mother actually
coped immensely well with this finding. However those who know the scientist
in me will understand the difficulty it presented to me. This experience has
helped me to accept there is not always a reason that can be explained by
our current knowledge. I wonder if a midwife had not "observed the baby to
deteriorate at the breast" that some people might not have also put forward
the reasoning that Stacy reports.

The most sad thing (that still makes me cry when I recall it) is a
confidence the mother related to me before the funeral. This was her second
baby. The first had been a very demanding breastfeeder, "always on the
breast". She had always picked her up at the slightest little squirm or cry
and believed this had led to her demanding behaviour. She had resolved that
she would not pick up this new baby "more than was necessary" After the 1st
feed the baby lay very quietly in her cot next to mum's bed for those next 8
hours. Many times mum wanted to pick her up, just to hold and cuddle her,
but had resisted these instincts, due to the resolve she had made. This,
even more than the death I think, caused her tremendous grief. This mum went
on to have a healthy baby the following year.

I have found through these experiences that the mother becomes very attached
to the staff associated with the birth and and care of the baby. I think
probably this is because we are the only ones (along with the partner) who
have intimately shared in their babies lives before they died. I would feel
very sad for this mother if she were not able to access the support she
required from the staff caring for her and her baby due to such awful
"rumours" concerning the cause of death, which are highly unlikely to be
true and must make her feel terrible.


Cathy Fetherston
Western Australia

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