I recently received an Obstetrics Unit Survey inquiring about my experiences during a maternity stay with your hospital last month. My personal care was largely pleasant and a significant improvement over my experience delivering my daughter at another local hospital. However, it was my experiences during my son’s time in the nursery that have prompted me to write you this letter.
My son was born on 7/14/2016 12:10pm at 38 weeks gestation, and soon indicated signs of oxygen insufficiency. The cord was quickly cut and he was whisked over to the exam cart, where he was put on oxygen. Soon after, he was taken to the nursery with my husband following closely behind. I joined the 2 of them in the nursery and learned that a chest X-ray had revealed nothing conclusive regarding the source of his oxygen problems, and they had put him on 2 intravenous, broad-spectrum, prophylactic antibiotics due to concerns regarding my 36-hour ruptured membrane, while awaiting the additional results of a 48 hour culture.
I expressed deep concern regarding the administration of any antibiotic, unless absolutely necessary. I informed them that I was well aware of the infection risks associated with my ruptured membrane and took special care to mitigate the risks by limiting exams, etc. However, my pleas went unheard and the intravenous antibiotics were continued. It was explained to me that if his symptoms were the result of an infection, the 48 hour culture result window could prove too late to administer them effectively. And since conventional medicine does not acknowledge the inherent risks of antibiotic administration, it is seen as a harmless preventative measure.
- Reducing unnecessary antibiotic use in the neonatal intensive care unit (SCOUT): a prospective interrupted time-series study.
- The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases.
- Neonatal antibiotics in preterm infants and allergic disorders later in life.
- Antibiotic perturbation of the preterm infant gut microbiome and resistome.
- Antibiotics and the developing infant gut microbiota and resistome.
I spent nearly every waking moment at my son’s bedside during the 5 days he was in your care, and I overheard an explanation similar to ours conveyed to virtually every parent – that of the necessity of prophylactic antibiotics for their infant, regardless of the circumstances. While I appreciate your fervor in proactively treating a potential infection, antibiotics are hardly innocuous and pose potential chronic, long-term health consequences that we arguably do not yet fully understand – especially when administered early in life. (Incidentally, all of my son’s tests regarding an infection were negative.)
There were a number of other concerns I witnessed in relation to the care of infants in the nursery, which compelled me to spend every moment I could with my son and to personally introduce myself to the nurse who would be caring for him during their 12 hour shift, as well as the NP and neonatal MD currently on staff. Suffice it to say that the level of care and attention he received varied greatly, depending on the individual assigned to him and their current workload.
My son was successfully taken off of oxygen the same day he was born, but kept in the nursery an additional 4 days while being weaned off of the IV and then treated for minor jaundice. We have learned based on studies of babies born via C-section vs. vaginally that an infant’s early microbial environment strongly influences their subsequent intestinal colonization. Such studies have also demonstrated the preferential species of Mom’s, Dad’s, and their home’s native bacterial diversity over that of a hospital environment (especially in cases where antibiotic administration has destroyed the colonization received during birth). Consequently, I would expect an infant to be released to go home as soon as it is deemed safe, especially if Mom has already been discharged. However, my experience did not reflect that standard and I witnessed another mother have a heated discussion with the NP and neonatal MD regarding the discharge of her daughter from the nursery. Ultimately, your staff conceded and allowed the parents to take their infant home as requested.
In your effort to achieve a truly ‘Baby Friendly‘ status, I would advise you to thoroughly evaluate the likelihood of an infection and the associated risks of antibiotic administration before deciding on a course of action, and release an infant once the critical health issues are resolved. In addition, you might explore opportunities for additional individuals to help with feeding and soothing the infants, in circumstances where the nurses are too overwhelmed to do an effective job on their own.
I appreciate your time and attention regarding these matters, and you are welcome to contact me via this email address or telephone at XXX-XXX-XXXX if you would like to discuss them further.