Nobody likes a tattletale. We’ve heard this since childhood and most of us teach this to our children when they begin playing detective about age 4. But there are times, in my experience, where one must step out of our “don’t get involved” comfort zone and embrace our inner Gladys Kravitz (Bewitched). When it comes to the safety of children, we have a responsibility to protect those who can’t protect themselves. The only question about this fact is when to make the call if you suspect something isn’t quite right.
Failure to Thrive
If you believe a baby is starving to death — call the authorities.
Failure to Thrive is a real condition. According to the National Center for Biotechnology Information, a division of the National Institute of Health, Failure to Thrive is a description given to children who are significantly below the current weight, or whose rate of weight gain is significantly lower than the average for children of the same age.
There are many reasons this can occur, including metabolic disorders, Down ‘s syndrome or other chromosome issues, and organ disease. However, it is also common in children who suffer from abuse or neglect.
I recently encountered a child, a 5 week old infant, who appeared gaunt and severely underweight. The child belongs to a young mother, aged 21, who also has an older child, aged 17 months. The older child appeared healthy, both in her weight and her energy levels. But the baby was just plain skinny. His little eyes were bulging and the mother complained that he couldn’t hold down his food. She’d taken him to the doctor and they were trying various formulas, both soy and hypoallergenic. Nothing seemed to be working. He cried often and she thought was colicky.
My partner fed the baby one afternoon shortly after we met this young woman, and the baby held down his food without problem. We were tending the children overnight because the mother wanted to celebrate her 21st birthday with a trip to the city, a couple of hours away. So we were able to feed the little guy several times. We did have to feed him 1 oz. at a time and burp him often, but he held down 4 oz of regular formula without issue at each feeding. Earlier, we’d noticed that the infant’s bottle was usually propped while he sat in his car seat/baby carrier. After having success feeding the baby during this overnight visit, we impressed upon the mom how important it is to feed your child in your arms; not only for digestion, but for the mother/child bond that develops.
She insisted she would do so in the future.
We weren’t certain about what kind of person she was, and we weren’t sure we wanted to develop a friendship with her. However, since she had expressed feelings of isolation and loneliness, we decided to keep befriending her for the sake of the children.
A few weeks later, she told us she was going out of town for five days. She expressed concern over having to leave her children in the care of her children’s father’s family. We immediately volunteered to help her out and arranged to care for the children for the week. We had known her for approximately 4 or 5 weeks at the time of the request.
Suspicion of Neglect
If you notice severe diaper rash, constant non-interaction with a child, and dismissive attitudes toward the most basic human needs — call the authorities.
When we tended the children on the mother’s 21st birthday, she informed us that the older child had an abscess on her bottom and that we should try to keep the area dry and clean. Upon inspection, it seemed more like ulceration than an abscess, but we followed her directions, applied a prescription medication and thought about taking a photo of the sore. I now wish we had. While we suspected the sore was the result of severe diaper rash, we decided to keep an eye on it during future visits. For the moment, we made sure the child was dry and clean.
When the mother returned the following day, she did not hug her children, specifically the infant. Instead, she pulled the sleeping, 6 week old infant off my partner’s chest by one arm and all-but tossed him straight into his car seat. We decided again we would spend as much time as possible with the children and offer to babysit every chance we could.
On the next visit, when we tended the children for the five days, the mother dropped the children off at around 1 p.m. on a Saturday. She spent roughly 3-5 minutes giving us instructions, including directions for administering an antibiotic for the infant, but most importantly that the child’s father’s family was forbidden to see him, and we weren’t to shop with the baby at specific stores because his grandmother worked there. She told us he had an abscess on the small of his back, that she had taken him to the doctor and received the prescription. There was a second prescription that we were to fill if the abscess hadn’t reduced in size by half on Tuesday of the following week. We later learned that she had taken the baby to the Emergency Department on Friday and neglected to fill the prescription until Saturday.
We gave him his first dose of the antibiotic that evening at bedtime. We didn’t know this was the first dose. We thought the doctor’s appointment had been earlier that day, i.e. that morning, and the morning dose had already been administered.
When we looked at the abscess on his back (after the mom had left as she was in a hurry to start her vacation), we were shocked and very concerned. We’d never seen anything like this on an infant. We are parents to seven children, and stand-in grandparents to half a dozen children under the age of 4. My partner wanted to lance the abscess, but we decided against it, as this was not our child and lancing a wound is an invasive procedure. The next morning, however, the abscess burst of its own accord, filling back up with fluid within the time it took me to mix a bottle of formula.
We immediately took him to the Emergency Department of our local hospital. After several minutes, which included learning that his weight the day before was a mere 8 lbs (this child is 2.5 months old), it was apparent that something was very wrong.
As far as the abscess, the doctor suspected MRSA (Methicillin Resistant Staphylococcus aureus ‘” pronounced “MERSA”), a very serious, possibly disfiguring and sometimes fatal strain of Staph that is generally found in nursing homes and long-term living facilities where bedsores are sometimes inevitable. I later learned that a combat veteran friend developed a MRSA abscess while serving in the Iraq war; that it had developed after a six week operation where he had been unable to shower for the entire time and had worn the same clothing continuously. (He was appalled that a child so young could have been exposed to this bacterium at all.)
My partner and I looked at each other and realized this child spent far more time in his car seat carrier than even we’d suspected. Because MRSA must enter the system through an open would, we suspected that the baby had been developing a bedsore where his back was in constant contact with the car seat. We relayed this fear to the physician. When we showed him the car seat, and mentioned our concerns about the condition (quite frankly, it smelled terrible), he immediately called the OB floor and requested that a new one be delivered to us in the ER. He also stated, based on a physical exam of the baby, that he was referring the matter to the State of Utah Division of Child and Family Services.
We were very relieved. While we desperately wanted to be role models to this woman, who needs help when it comes to raising and caring for children, the help would be too little, too late.
If you’ve tried to help and know the parents of a child have been educated about absent or harmful behavior and the parents refuse to make changes — call the authorities.
We spoke to the mother shortly after the doctor made the decision to admit the child for IV therapy and observation. When I couldn’t pronounce the name of the infection (I’d only heard it the one time, and I thought it was something along the lines of “Mersa” or “Merci”), the mother immediately stated, “It’s MRSA.” I was shocked.
“You know?” I asked.
“My daughter had it last month. I know that’s what it is.” She sounded inconvenienced more than upset.
I’m not sure why, however, because when I asked if she could get to the airport quickly, she stated flatly, “No.” As if she couldn’t understand why I would suggest such a thing.
Her child spent the next three days in the hospital and she did not fly home. Her page on a popular social networking site indicated she was blissfully happy visiting her current lover on the East coast and that she was having “a blast.”
Upon admittance to the hospital, the baby weighed 9 lbs. We’d managed to increase his body weight an entire pound in less than 20 hours. When he was released to our care and control on Tuesday afternoon, he weighed 11.5 lbs. That is an increase of nearly 50% of his body weight just 3 days earlier. It was obvious that the child wasn’t suffering from some stomach malady (other than hunger), did not have reflux or colic, and the mother was still propping the bottle to feed him remotely: something she promised us she was no longer doing. Of note, as well, was the child’s energy level. An infant who had been lethargic and nonreactive to external stimuli was now cooing in response to attention and “conversation”, and smiling when we tickled him.
My mother used to tell me, “Where there’s smoke, there’s fire.” My father told me that if something looked like a goat, smelled like a goat, sounded like a goat and hung out with goats — it was a goat.
We learned much that hadn’t been shared with us by the children’s mom over the course of the next three days. The social worker who responded to the hospital early Sunday afternoon eventually put all of the pieces together and realized this child had the same mother as the baby girl with MRSA the previous month. We learned that the nurses remembered this mother specifically because, even with a severe infection (the older sister was hospitalized for 2 weeks), she refused to change the girl’s diaper when instructed to by hospital staff. We learned that the older child’s diet consisted of energy-drink type soda products and candy. We learned that the mother had a history of drug abuse. From the mother’s words and attitude, we learned that she was more upset about DCFS involvement than in the welfare of her child.
The social worker learned that the baby weighed 8 lbs, and had gained an entire pound in less than 1 day in our care. She learned that the ER had confiscated and planned to destroy the car seat as biohazard waste.
Because of the holiday weekend, and the fact the baby had been admitted for inpatient treatment, the mother was not returning home, and we had taken all the proper steps to ensure the welfare of the children, she allowed the older child to remain in our home, where she was obviously safe. She spoke with her supervisor on Tuesday, however, and they made the decision to remove the children and place them in formal foster care before the mom came home, late Thursday night, early Friday morning.
They are allowing us one more night with the kids. I rocked the toddler to sleep tonight, as I have every night that she’s been with us. My partner is lying beside me with a little miracle in her arms. I packed their new diaper bags with all of their belongings. I have taken dozens of pictures.
We had hoped beyond hope that the State would allow us to foster the children, perhaps with the mother’s agreement to leave the children with us, but the severity of the matter requires them to take action before the mom returns. They have learned she is planning to move with the children immediately upon her return, probably due to the DCFS interference. They can’t risk her taking the children away. We considered taking the classes to become foster parents in an official capacity, but we realized that if we insisted the children be returned to us in six months, we’d be almost no better than their mother; putting our needs in front of theirs.
The older girl’s infection became so severe that a large ulcer has scarred her bottom for life. An infant with the same severity of infection could easily die, especially one so undernourished as he. We did what we felt was right, and while we didn’t personally call DCFS to intervene, we were thankful the doctor took that responsibility away from us.
We are not nosy. We are not judgmental. We wanted to offer our help to this woman, but she wouldn’t listen, and continued to neglect her children. I can only hope she learns from these events and doesn’t have any more children in the future.
If she does, I hope the next total strangers she leaves her children with are more like us, than her.