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Subject:
From:
Linda Madsen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 4 Sep 2000 05:14:09 -0400
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I am a Pediatric Advanced Life Support (PALS) instructor as well as a NICU/pediatric nurse.  It should raise a red flag for any health care provider who sees an infant with a respiratory rate over 60 for any sustained period of time. Emergency staff in the hospital should be certified in both neonatal & pediatric life support.  I would definitely followup with the mother to be sure that the baby is examined by a pediatrician if not a neonatologist for further workup as soon as possible.

We recently had twins be readmitted to our hospital two weeks after discharge from our unit.  One twin never "got the hang" of breastfeeding consistently & dad wanted to have one baby that he could feed.  Both came in with a respiratory tract infection passed on from their 4 yo sibling.   Only (and I know you can all see where this is leading) the breastfed brother was able to be managed with good pulmonary toilet & tube feeding for a couple of days.  His brother had cardiopulmonary arrest & was intubated in the outlying hospital prior to transfer.  He spent a week on the ventilator.  Despite discussions with both of the LC's working at the time & mom's stated wish that she wanted to try breastfeeding again with the second twin, she only put him to breast twice & pumped milk for him four times.  She told me more than once "he's his father's baby" and she responded to him so differently from his twin.  He also developed an elevated respiratory rate with bottle feeds despite gaining weight on his AIM.  The doctor got a followup chest x-ray 48 hours post-extubation & the child had bilateral infiltrates.  Turns out he is a silent aspirator and his only symptom was his fast breathing. I think this may also be why he never seemed to "catch on" to breastfeeding while in the NICU but he seemed to do well with bottle feeds with his dad from outward appearances.

I'm really saddened by all that he's missing out on that his brother is receiving.  The repercussions are so far reaching.  It's a miracle that he made it through his arrest but I still feel like we all let him down.

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iWon.com       http://www.iwon.com     why wouldn't you? 
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