Monday, November 20, 2006

Creative

About a week ago I wrote about a pair of 27 week gestation twins who concerned us because of questions regarding the mother's parenting skills. Unfortunately, it turns out that we had good reason to be worried.

One week after going home one of the twins developed some apnea, a breathing problem where kids just sort of skip taking breaths. The mother brought that baby to the hospital and the baby was admitted. So far, this is not too unusual, since premature babies often need to be readmitted to the hospital after discharge. The real problem comes with the second twin. The baby was on iron drops for anemia, and there had been some problem with the bottle the iron originally came in, so someone in the home had put the iron into a regular baby bottle and put it into the refrigerator. While the mother and father were in the emergency room with the first twin, someone else in the home fed the bottle containing the iron to the second twin, apparently thinking it was juice or something. That twin developed iron poisoning and was rushed to the hospital and put on a ventilator. Her iron level in the blood was over 1,000; it's considered severe poisoning if the level is greater than 350.

When we heard about this in the NICU, we hardly knew how to react. We were frustrated with the situation, of course, and wanted to be angry at someone, but at whom should we be angry? You can't really be angry at someone for being stupid, can you? Also, it's not clear who did the damage here. Who put the iron into a baby bottle - stupid enough - and then put it into the refrigerator? Who fed it to the baby? There are several siblings of the mother in the home, and some small children as well.

Sometimes it just seems so hopeless. People are so creative in their stupidity that there is no way to anticipate and thereby prevent every possible thing that can go wrong. We can, I guess, only try to prevent kids from going to bad homes. Maybe we're a little angry at ourselves for letting these kids go to this home, but realistically Protective Services cannot and will not remove kids from this kind of home if nothing has gone wrong. We'll have to wait to see what happens now.

P.S. Check out the new pediatric grand rounds at Aetiology.

10 Comments:

Anonymous Anonymous said...

Call the county and get the kids in foster care before this imbecile mother kills them!

11:50 PM  
Blogger Laura said...

this is absolutely heartbreaking!

1:10 AM  
Anonymous Anonymous said...

poor little kids,this makes me physically ill

6:06 AM  
Anonymous Karinsamira said...

First time poster here...

First I want to say that your blog is very fascinating to read, as someone who was born at 34 weeks back in the seventies the topics you blog about here are just so interesting to me!
Ok, what I meant to say re the situation of the preemie twins...could it not be that you are a bit too harsh with that family because those people are poor and uneducated? Of course such things like poisoning a tiny infant with iron should not happen, ever...but: don't you think that those kind of things also happen to people who are way better off socioeconomically...they just are a. better at covering up such an incident and b. are not automatically accused of not caring well for their young ones when such a thing happens. I know this from first-hand experience...back in 1976 when I was born and subsequently put up for adoption I was given to a family where the father was an MD. Well, they treated me poorly and the placement failed some weeks later...I landed in the hospital in a very worrisome state.Do you think that someone ever bothered to inquire what had happened? Nope...they just got another kid and I ended up being labelled "special needs" .
What I want to say with all of this is: would you think the same way about this family if they were wealthy, white and had a good education? Just wondering...

Karinsamira

8:28 AM  
Blogger My Heart On My Sleeve said...

Things that make you go "siiiiggghhh".

1:12 PM  
Anonymous Stacey said...

Do you think the babies will be okay? What are the affects of iron poisoning in a baby that young?

1:57 PM  
Anonymous Karen in KC said...

Whatever the socioeconomic status, there is no excuse for ignorance... it is the same as neglect. If the child needs medicine, it is the doctors' job to explain the whys and the risks and the parent's job to ask for clarification if they don't understand something. If these babies are the same ones ND has discussed in previous posts, I think this mom had some developmental issues of her own, in which case the responsibility falls to her guardian.

I really hope these babies will be okay. Although I have limited knowledge of the effects of iron poisoning, I do believe that baby is (un)lucky to have survived at all.

4:45 PM  
Anonymous Liz said...

This makes me ill. Given the situation, the babies should never, NEVER have been discharged to this mother.

12:56 AM  
Blogger neonataldoc said...

Thanks, everyone. Karinsamira, you make a fair point. I think that sometimes abuse and neglect can be missed in higher socioeconomic folks. But I think I would have thought this mother stupid regardless of her class. She just wasn't smart. Nice, but not bright.

Stacey, and others, I'll try to get some follow up on these kids, to see how they are doing.

5:48 PM  
Blogger fancypantsnancy said...

This reminds me of the story about our former surgeon general. C evertte koop- when he was a practicing pediatrican he seperated some conjoined twins from a third world country.Subsequently one of the twins choked to death on a bean. The point im making is that life is dangerous,that is why we have child proof caps on drugs and why iron is not a part of pediatric vitamins anymore. Years ago I worked in a hospital that seemed to have at least one accidental iron poisoning a month. I doubt all these parents were bad,maybe just ignorant or distracted for one minute. Also did anyone educate them on discharge about the potential for this? As a doc you are a caring person and you care about your little patients but sometimes stuff just happens.

9:31 PM  

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