Baby's brain damage revealed
Four midwives and the MidCentral District Health Board breached the rights of a newborn Horowhenua baby who was brain-damaged as the result of low blood glucose levels, Health and Disability Commissioner Ron Paterson has found.
The complaint dates back to July 2003, and hinges around whether the midwives paid enough attention to the quantity and quality of the baby's feeds and nappy contents.
The baby was born at full-term, at a healthy weight, at Palmerston North Hospital, and was transferred to the primary maternity unit at Horowhenua Hospital next day.
That unit has since been replaced by facilities at the Horowhenua Health Centre, which has achieved Baby Friendly Hospital Accreditation for its support of breastfeeding and infant nutrition.
The baby was treated with phototherapy for jaundice, a practice known to increase the risk of dehydration. Wet nappies are a key indicator the baby is getting enough fluids.
Two days after birth, the baby became increasingly uninterested in feeding, was lethargic, losing weight, his temperature dropped, his movements were jittery, and he was jaundiced. A midwife acted on the third day to feed him expressed breast milk, but the baby became more unwell.
His mother told the commissioner she felt midwives had not listened to her as she became increasingly concerned about the baby's condition.
By the time he was transferred back to Palmerston North Hospital's neonatal unit, he had suffered a bleed into the membranes at the base of the brain that left him disabled.
MidCentral Health has since improved the type of charts it asks midwives to fill in, to get a better record of signs that babies are feeding and getting enough nutrition and fluids, and requires more thorough care plans.
The commissioner commended MidCentral Health for the improvements. He found that although the charts the midwives were expected to fill in at the time were inadequate for picking up danger signals, they had a professional responsibility to have done more than those charts required.
Three of the midwives have apologised to the parents. The fourth has been told to do so.