How much power do we have?

[~ Mylitta ~]

I'm just curious if anyone knows how much power parents have vs how much parents doctors have when it come to babies after birth?

That's pretty vague, so I'll give an example...

When my daughter was born the paediatrician discovered a heart murmur. My daughter had a PDA (Patent Ductus Arteriosus). The duct between her arteries was much larger than normal (more than twice the size of her actual arteries) and the concern was that it may either not close over and require surgery to close it, or that as it closed it may pull on her artery and cause a narrowing which would compromise blood flow to her body. The third option was that it would close over within a few days and not cause any problems (which is thankfully what happened. She was technically admitted to SCN but was able to room with me for most of the time on a mobile oxygen saturation monitor to monitor her oxygen level. If it dropped we would know she needed attention. In the end we stayed four nights and she was given the all clear.

Just wondering if in a situation like that, can the parents choose to not admit into scn and take the baby home if they get an oxygen saturation machine themselves so that they can monitor their child at home? I know you can buy or even rent them. Or if the doctor says the baby must stay in scn is that the final say and the parents can't do anything about it? I'm sure we probably would have just stayed at the hospital anyway, but I'm more just giving this as an example to find out how much power the medical profession have over the parents.


EDIT: Another example would be when someone has a premmie in hospital and the only thing that is holding up discharge is weight gain. If there is nothing else wrong with a baby and it just needs to gain a little more weight before the doctors want to discharge it, can the parents step in and make the decision to take the baby home and monitor their weight at home instead?

[Little Chicken]

It is much different with kids then with adults. If medical staff feel that a child is in danger because of a parental desire to discharge early against medical advice, they can get court orders compelling treatment.

In your examples though, weight gain in preemies is very important, as most are significantly underweight, and failure to gain at the outset with normal feeding can lead to greater problems down the track.

With home oxygen monitoring. You can't just rely on the monitor alone, you can have normal readings, with bub's showing very ther sign of heart failure. Also, what would happen if the oxygen reading dropped and didn't pick up with stimulation, with no oxygen or suction around?

[~ Mylitta ~]

I understand that the doctors obviously have reasons for wanting to keep a baby in hospital, but even with the weight gain example, if a baby is being solely breastfed in hospital and their weight is just being monitored, how would that be any different to breastfeeding at home and monitoring the weight just as much.

Hmmm, and I wonder if the "competence" of the parents makes any difference to when a baby will get discharged...? So if you have a parent with a medical background, will the doctors be more inclined to allow them to discharge their baby earlier?

What got me thinking about this was watching a show about a couple that had quads in America and two of them went home with heart rate and apnoea monitors and were also still on oxygen. I thought it was pretty impressive that they were able to take them home at that point in time.

[Novella]

Mylitta to answer your second question I believe parental competence does come in to play. DD2 was born at 35+6 as you know and she was doing well, the paed wanted her to stay in as she was early (that was the only reason) my midwife advocated for me to take her home and the fact that I was a mother already and a nurse with paeds experience was taken into account and we left the next day with daily midwife visits, however my DD was not ill and was feeding and we had the midwife monitoring weight gain (I was in the group practice to got multiple post natal home visits, if I was in the mainstream system this may not have been able to happen). Sometimes parents can take babies home for trials with weight gain and are discharged on short term leave, often bringing babies in daily for weighs.

I wonder in the TV show if it was a long term issue. Often with long term medical problems parents will be given intense education prior to discharge for ongoing medical needs and how to use equipment, this is very expensive though. Short term issues or those that may need immediate intervention tend not to be discharged with medical support but are treated in hospital.

I guess another factor as little chicken mentioed in that orders can be granted to compell medical treatment in regards to children, this is a very difficult area to tread but normally the treatment must be deemed to be life saving, so in a regular scenario a vaccine is unlikely to be deemed something that a dr would want to get a court order over but perhaps in the case of a HIV +ve baby it may be an issue that could be bought before the court.

So many different scenarios, its hard to think there may be a time when what we want for our children is overruled.

[Little Chicken]

There has been a court case compelling a set of parents to give a baby hep b vaccine and immunoglobulin because mum was positive, but they refused and went into hiding, I think dad was facing prosecution.

Yes, competence does play a part, especially likelihood to attend follow up appointments. As for weight gain, mostly in my experience, it is babies who a failing to gain or losing weight that would be most likely to remain admitted.

[Novella]

Lc that was the case that came to mind, I never knew the outcome though