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T A B L E++T A L K Grandparents who dote, and those who don't. Discuss your kids' relationship with your parents in the Mothers area of Table Talk - - - - - - - - - - R E C E N T L Y Ballad of a bohemian childhood Wax on Second Thoughts Drama Queen Candidates
How to ruin your kids' summer vacation BROWSE THE MOTHERS WHO THINK HOT FLASH ARCHIVES - - - - - - - - - - Mamafesto
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NURSING DEATH | PAGE 1, 2
Who is responsible for this baby's death then? Lawrence: We tell new mothers that a baby should be seen within a week of leaving the hospital. If the hospital had just weighed the baby and examined the mother's breast, they could have gotten a good sense of whether or not she had a supply of milk. So I don't know, is the clinic culpable? How culpable are her relatives who were aware of this? Did this happen because she was poor and didn't have as much access to the health-care system? Aubry: The baby died because she was ill. The mother apparently knew this because she brought the baby to the clinic -- but then she was turned away. So shouldn't these people be accused of being involved in this baby's death? Is it an economic problem? Yes, which translates into a health-care availability problem. Here we are trying to knock ourselves out, encouraging the poor to breast-feed because of all the advantages, but where do they go if there's a problem? If there are risks with breast-feeding, they certainly would be higher in the people who are asked to do this and then not given the support necessary to minimize the risk. For example, if an affluent mother has trouble breast-feeding, she has access to several private pediatricians, 24 hours a day, seven days a week. Whereas, what do you think would happen if an indigent mother calls the clinic at 5 o'clock? Not too likely she'll get an answer back, and if she does, it's probably not going to be a trained person or a breast-feeding counselor. Is it possible that Tatiana Cheeks had a problem with her milk supply that might have led to the baby's death? Is that common? Lawrence: It isn't common. We don't know really what the percentage is of women who can't provide enough milk because we don't know how many women out there can provide enough milk. In a pediatric clinic, they might see two mothers a year who have trouble making enough milk. Often when an individual practitioner sees a mother who is not producing enough milk, it's usually that she didn't have the proper help or guidance. Sometimes it's because the baby wasn't put to the breast properly or the baby didn't stimulate the breast and the breast didn't respond by making enough milk. If she had been seen in the clinic, maybe this could have been fixed. Rarely, you see a mother who just tries everything -- has gone to classes, read the books, has had all the help in the world from experienced lactation consultants and still cannot produce enough milk. In that case, it's something inherent that you can't do anything about. Would the baby have been better off if she were bottle-fed? That way you can at least see how much is being consumed. Lawrence: With bottles, yes you can measure how much the baby is drinking, if that's your only goal. But failure to thrive among bottle-fed babies and babies who are not held is much more common than among breast-fed babies. The one thing about breast-feeding is that you have to have that body contact, whereas a mother can ignore her bottle-fed baby by keeping it laying in the corner somewhere and popping a bottle in every once in a while. [Problems occur] when formula isn't prepared properly -- either by overdiluting the formula or not sterilizing it properly. Would it be hard for an inexperienced mother to tell if her baby was properly nourished? Lawrence: All hospitals tell mothers the following: You want the baby to wet at least six to eight diapers a day, you want the baby to have three or four stools a day, or at least one per day. The mother should also have some sensation of her breast filling a little and becoming softer after a feeding, she should see milk in the baby's mouth and her breasts should drip when stimulated. There is a litany of things that we tell mothers to look for and if there is any faltering, they should be seen. Do you think cases like this will change the way breast-feeding is looked at? Lawrence: I hope not. What we need to change is follow-up after babies leave the hospital. We need to make sure that newborns are being seen. Breast-feeding has tremendous benefits: It decreases infection and the likelihood of illness in general; it decreases the cost of medical care and food in the first year of life; and in the long term, it decreases allergies and increases intelligence. You want to sweep all those benefits out the door because of one case where a baby dies who happened to be breast-fed? I hope not.
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