Sharone, this is indeed a challenging situation, poor mom! Much of this case is beyond my abilities/training, however, I will tell you that there is very little that can be done to help the baby without first addressing the needs of the mother. Until she has the appropriate care plan in place and working, she is unlikely to do any better with the children. Medical intervention does seem indicated, mom may be suffering from either postpartum depression or bipolar disorder (or other dx). As I'm sure you know, if left untreated, either of these dx can have tragic consequences. Perhaps it's time for a "changing of the guard" with her health care providers. A new face with a fresh approach may be able to gain mom's trust and compliance. I urge haste. While mom's threat to mix drugs may be call for help, it must be taken very seriously as a possible suicide threat. Perhaps the best short term approach might be for mom to be hospitalized in order to get close supervision on her treatment and medications. Of course, we hope for a patient advocate, such as yourself, who can help keep the mother/baby dyad in the picture along with maintaining the nursing relationship. You haven't mentioned the father. Is he involved? Can arrangements be made for a trusted relative/friend to care for the children until this situation is under control? Bless you for the compassion and perseverance you have for this mom and her family, she is very fortunate to have you. -- Denny Rice, RN, IBCLC Dallas Texas USA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html