Food for thought ..for L and D nurses

[Beandawgs]

Just food for thought - been thinking alot recently about my first son's birth (he's now 15) - I'm Type I diabetic, and my son was born at 38 weeks via c/s with general anesthesia due to severe fetal distress during induction. I had been in the hospital since two days earlier, lots of cervidil, then pitocin trying to deliver lady partslly. OB broke my water then about 3 hours later he went into distress , OB realized he was in a brow presentation. This was in a fairly large suburban hospital with a level 3 NICU - but they couldn't find the L&D anesthesiologist for some reason he wasn't responding to pages/calls and wasn't with another patient. So no time for epidural when he finally did make it to the OR - the OB had already started cutting. Horrible event still dealing with anger about all of this - earlier that morning I had asked the OB to go ahead and do a c/s because I wasn't making any progress with the induction - her response was "you told me you didn't want a c/s". Anyway, so I didn't get to be a part of his birth when I woke up in recovery didn't get any info on my baby's condition - but finally got to see him for a second when they wheeled me past the nursery - to be told they already bottlefed him b/c his blood sugar was low - even then I had specfically told them on admission I was breastfeeding. Then to make matters worse - they kept him in nursery all day saying they wanted to monitor his temp (he was cold earlier). Wasn't until my sister in law came and demanded to get the baby in the room did they bring him - breastfeeding was a nightmare and ultimate failure despite us hiring a lactation consultant to come to the home - he had bad tongue thrust and I keep wondering if that first bottle was the killer. Had another son a year later at 36 weeks, planned c/s went very well, my new OB knew my story and did a fantastic job updating me and baby was with me in my room less than an hour after birth - and nursing right away - until he was almost 2 :-)

The reason why this is on my mind so much is that my 2nd son (who is 14) has now been diagnosed with a serious immune deficiency called CTLA4 insufficiency and may need a bone marrow transplant. They are finding out I have the same insufficiency which is why I have T1 diabetes. Part of this CTLA4 problem is severe gut inflammation and lack of IGA (which breastmilk is full of). I think my breastfeeding may have saved his life - he doesn't have the severity of gut inflammation that most peoplewith CTLA4 have. I pray, pray my older son doesn't get this disease. Of course more so than now I worry that lack of breastfeeding could have set him up for problems in future. I do hope that more L&D staff respect mom's wishes to breastfeed and especially try to keep c section moms and babies together - even when mom has had general. I also wonder if L&D nurses realize that breastfeeding for some of us can be life saving.....thoughts?

[hppygr8ful, ASN, RN, EMT-I]

I understand your concern and questions. I had a very similar birth experience with my Man Cub (now 16). I think that the mother's wishes should be honored when ever possible but you also have to understand that if your son's blood sugar was low and you were unable to BF due to being under anesthesia action had to be taken for your son's safety. When my son's blood sugar dropped he began having seizure activity and an immediate transfer to a NICU in another hospital. Today my son is a happy , healthy Junior in high school with no problems at all. So I am thankful everyday for they actions the staff took on my son's behalf.

It's interesting that even with immediate breastfeeding your younger son developed problems while your older son who was not breastfed did not have these problems. While I agree the breast is best it's not always possible and babies have to eat.

It appears with just cursory web search that the CTLA4 insufficiency is due to a genetic mutation and it can be tested for. Why not have your older son tested and remove all doubt?

15 years is a long time to still be dealing with anger over the circumstances of your first son's birth especially since he is healthy. I hope you are able to find some peace. I know only too well how stressful it is to have a birth experience that did not go as planned but the fact that you have a healthy teenager is all that matters at this point.

Hppy

[traumaRUs, MSN, APRN]

I am so very sorry your son is so ill. I do understand your frustration and anger over your son's birth.

However, these are questions we just can't answer on AN.

I'm very sorry. As above poster asked -maybe your older son could be tested for this? Probably something best addressed with his pediatrician.