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Subject:
From:
Gladys Mason <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 20 Sep 1996 11:13:14 EST
Content-Type:
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     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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