Tag Archives: breastfeeding sick babies

The children’s hospital responded to my letter

A few weeks ago I wrote about my rocky road back to work from maternity leave and our trip to accident and emergency in the local children’s hospital when the baby got dehydrated from gastroenteritis.  After some encouragement from Anne-Marie of www.aboutbirthandbabies.com, I decided to write to the hospital about the incorrect breastfeeding advice that the doctor gave us. As Anne-Marie pointed out in her comment, not everyone might be confident enough to challenge the advice of a doctor and I thought it was important to bring it to the hospital’s attention.

I won’t share my letter with you here because I waffled on a good bit and your time is precious, but to summarise, I described the events of the night, the advice we got, the reasons I felt it could be damaging, asked them if they had a breastfeeding policy and requested that their doctors receive continuous professional training  in treating breastfed babies. I was at pains to point out how absolutely brilliant and attentive the doctor was outside of the breastfeeding advice. She really was. Out of courtesy, I also informed them that it was likely I would publish their response on my blog.

I received a really positive letter in the post today from the hospital’s paediatric emergency medicine consultant.  I thought you’d be interested in what she had to say:

“Thank you for raising your concerns with our team, thus giving us the opportunity to address this issue.  We as a department and hospital unequivocally support the HSE and WHO guidelines on breastfeeding and the advice you received was clearly erroneous.

(Redacted hospital name), as a national tertiary referral centre for a wide variety of neonatal problems, understands fully the importance of breast milk in the infant diet and the irreplaceable advantages it offers.  A hospital-wide breastfeeding policy is in place, and indeed our department has developed a number of clinical practice guidelines for our junior doctors to follow for a number of specific conditions including gastroenteritis.

Both this guideline and the accompanying parent information leaflet emphasise the recommendation that breastfeeding should be continued during gastroenteritis.  The parent information leaflet which you should have received, is attached.  The staff member who looked after (Baby S) on that evening, was unfortunately not familiar with the recommendation. We have found her to be an extremely hard working junior trainee who has recently joined us as part of her training in general practice.

I have discussed the issues raised with her and am satisfied that she is now appropriately informed to advise breastfeeding mothers of ill infants. Furthermore, we have put an education package in place for all trainees rotating through our department, which will be delivered at their commencement with us.  I trust that this addresses your concerns, and I thank you for highlighting the issue with us.

Your truly…”

I’m really happy I wrote the letter so a very big thank you to Anne-Marie for giving me the nudge.  It’s really reassuring to read how highly they rate the benefits of breastfeeding.  For me, it’s just one more confirmation of what a brilliant health system we have.  I know a lot of people have had negative experiences with the Irish health system, and it clearly has its faults, but on a personal level, I have had some really excellent care – from emergency health, to maternity care through to women’s health. It has been exceptional.  I do feel a little guilty for calling out the doctor who treated S because she was really lovely and a good doctor but I suppose that is the consequence of writing a letter of complaint in the first place.  The consultant ended the letter by saying she trusts she has addressed my concerns and in fairness, she has gone above and beyond addressing them.

Incidentally, you might also be interested in this quote from the information leaflet they sent with the letter:

“We advise that you offer small amounts of fluids frequently to your child – just like you have done in the Emergency Department. We suggest you continue normal feeds if your child is breastfeeding or formula feeding, you can also supplement with Dioralyte or another rehydration solution – ask the doctor before you go if you’re not sure which fluid to give your child.  Offer a drink each time they vomit or have diarrhoea.”

Good to know!

These boobs were made for working

Along with getting used to being back at work these past couple of weeks, I’ve also been balancing working and breastfeeding. I’m happy to say it’s been much easier than I was expecting. In fairness, my flexible working hours mean I’m not rushing in the morning so we’ve time for breakfast and then a little feed in the morning before we head off. S is doing really well during the day drinking his water and eating his meals at crèche. Once we’re together again in the evening, he’s having another feed straightaway which is then followed by a long, leisurely feed at bedtime which he’s enjoying for a long old time!

Since he’s been sick he’s actually sleeping much better and he’s only waking once or twice at night. We’re putting him down in his cot but if he wakes when we’re in bed ourselves, we pop him in with us where he has a little nurse and then we all snuggle down for a good sleep. If he needs a little nurse again later, off he goes and I usually doze through it. This is really working for us at the moment because we’re all getting a good rest and my God, do we need it!

I’ve had interesting reactions to my breastfeeding at work. I’m not shy about mentioning it because I don’t feel there’s anything unusual or wrong with feeding an 11 month old and I’m not prepared to be apologetic about it. I have seen some politely strained faces though, trying not to react but clearly perturbed. I’ve had a couple of comments but they’ve been made without the knowledge that my son doesn’t take a bottle, so people would be unfamiliar with how that’s managed and that’s okay.

The HR department have been great providing a room with a fridge for me to express in if I need to although really I’ve just needed to relieve the pressure once. I manually expressed, which I actually find really uncomfortable, so I’ve been carting around my brilliant Medela Swing in my handbag but it hasn’t been necessary so far. I think I’ll give it til the end of the week and then leave it at home.

I had a very frustrating conversation with a doctor in the children’s hospital where we took S to be rehydrated when he was sick. I was so disappointed that we didn’t see eye to eye on breastfeeding because she was so brilliant, really sound and very attentive. She was about the same age as me. It felt like we had quickly built a rapport only for it to be knocked down when she compared breastfeeding my sick son to giving him dairy. She suggested it would upset his stomach more, like yoghurt or cream. No mention of the antibodies or the hydrating properties or the comfort it provided. Or that I’m not a cow. She actually recommended that I actively avoid nursing him until he was ready to hold down solids.

Look, I let it go…quiet in my confidence that continuing to feed him was the right thing to do. I was super indignant for about twenty minutes where I was mentally composing my strongly worded letter to the head of the hospital about not pursuing a pro-breastfeeding policy for sick babies. But you know what? I’ll pick my battles. We couldn’t have asked for better care delivered with such speed and not everyone gets to say that, do they?

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