"Not enough support at Tameside neonatal"

About: St Mary's Hospital / Paediatrics Tameside General Hospital / Paediatrics

(as the patient),

May 2005, I was 7 months pregnant and admitted to St. Mary’s hospital in Manchester due to bleeding. They could not find the cause but kept me in. After a few scans, they said I had most probably been pregnant with twins, as I had a 2nd placenta and that was bleeding. They induced my birth at 36wks, and unfortunately my daughter wasn’t breathing properly and was a very deep purple colour and was whisked away to scbu. I visited everyday, although I myself was unwell. Anyway, after a few days scbu needed her bed for more tinier sicker babies and we were transferred to Tameside neonatal unit.

My daughter went ahead of me, she hadn’t started feeding yet, as she was tube fed breastmilk and we made it very clear to staff at St Mary's and the specialist ambulance crew that took her that she was to be breastfed. When I finally arrived a few hours later, to the maternity ward, I wanted to go straight to see my baby, but the midwifes kept telling me that I couldn’t and this just kept upsetting me until they gave in. I arrived in neonatal to find my partner trying to bottle feed the breastmilk to our daughter, I asked him what he thought he was doing and he said the nurses had told him that they had spoke to me on the phone and that I had instructed them to try bottle-feeding and not to wait for my arrival, this of course was untrue. I found it extremely difficult to try and get her to latch on to my breast following this, and was advised by Tameside hospital to either give up and give her aptimal (which they gave her whilst I wasn’t around, and I saw written in her notes I never gave consent and nor did the father), or bottle feed her my breastmilk.

My daughter was in their care for 3wks, and every day I would come to see her I would find her in a bed full of her own vomit with a paper towel shoved under her head on top of more vomit. When I raised this issue with the neonatal nurses, they told me it was my job not theirs to keep her bed tidy and that I knew where the clean sheets and blankets were kept. I feel that Tameside neglected my daughter at a vulnerable time in her life.

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Response from Philip Dylak, Director of Nursing, Tameside Hospital Foundation Trust

Thank you for submitting your comments. I am very sorry that you had cause for complaint, and that our services fell below the standards you and the hospital expects. Without knowing your exact details, we cannot respond to all of the issues you raise. However I hope the following will be of value. If the baby required a feed on arrival on the unit and mother was not available then the staff had the following options: • Tube feed the baby • Offer breast milk via a bottle Without being able to review the records, I cannot say whether the staff on the unit were informed that you wanted to breast feed the baby. I am unsure as to why the staff chose the method of asking the father to offer a feed of breast milk by bottle. Current thinking supports the offering of breast milk via a bottle occasionally, as it is not detrimental to breast feeding. The appointment of a breast feeding coordinator in the same year as your experience has enabled us to improve and promote breast feeding on the unit since you attended. Regarding offering formula milk, this would only be used if there was no breast milk available for the baby and she required a feed. The staff on the unit, recognise the benefits of breast milk for the pre term neonate, and promote its use. Regarding the baby lying in vomit, these infants have a tendency to vomit (sometimes in very small amounts) more frequently than full term infants, and the minimal handling policy supports not disturbing babies every time they vomit, unless it is a copious amount, and the bedding is heavily soiled and requires changing. If pre term infants are constantly handled and disturbed the tendency to vomit increases and that uses energy that they need to conserve to thrive and gain weight. If the baby vomits small amounts, dry soft wipes may be placed under the baby’s cheek to protect the skin until the bedding is changed at the next time the cares are carried out i.e. nappy change, observations etc. It is disturbing to hear that a mother was told it was her job to cot tidy. Occasionally, a member of staff may display an attitude that is not appropriate and if the attitude of a member of staff causes concern this is addressed as soon as possible with the individual concerned. I hope this is an acceptable response, and once again I apologise. If you would like to discuss your concerns further, please contact me at philip.dylak@tgh.nhs.uk.
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