Tag Archives: HSE guidelines

Why is treating tongue tie in breastfed babies an underground movement in Ireland?

It is not news to anyone I’m sure that Ireland has the lowest breastfeeding rates in Europe. Public health campaigns and two active Government policies to improve rates in recent years have failed to have any impact at all. A slight increase has been attributed directly to the increase of foreign nationals in the country and the fact that our population of older mothers is growing. Research indicates that older mothers are more likely to breastfeed their children. Continue reading Why is treating tongue tie in breastfed babies an underground movement in Ireland?

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!