Moral dilemma

[LadyEatsCrispsALot]

I met my best friends new baby of three weeks. She is adorable, but I have noticed some facial characteristics that lead me to believe she possibly has Downs Syndrome. I come from a medical background. My partner also met her and independently voiced his concerns of the same. He is also a medical background. I should mention my friend is not in the 'system' and chose not to have any scans or blood tests and had a home birth with an independant midwife. So do I tell my best friend our thoughts and risk our friendship? My main concern is an undiagnosed heart defect and if anything happened to the baby, I would hate myself for not saying anything. Or just tell her my worries and if she wants to follow it up then its up to her. It's really difficult. Any thoughts gratefully received.

I think you should say something. I actually can't think of any practical reason why you shouldn't. This is not a normal 'mind your own business' situation, not if you know she hasn't had any evaluations for this condition.

What is the worst thing that could happen if you said something?

Its difficult as she has gone down the anti medicine route, which is fine but sometimes that isn't always the correct course regarding child health in my opinion. She may not act upon what I state but at least I have voiced concern. She can then do what she wishes with that info?

Wont she have a health visitor even if she has gone private/home for her birth? If she doesn't go for the 6 week check (even without jabs) then that should flag up concerns. Could you have a word with the health visitor team that covers her area? They can do a home visit and try to talk her into seeing a doctor for just basic 6 week tests (if not immunisation)

She doesn't immunise

Well that's a whole other thread.

I agree with what someone said earlier, would she act on anything you said anyway?

Will she be having any health checks on the baby at all?
I would have thought she would want something even if it is private/independent
I think on balance I would ask along the lines of getting her checked over (the pead checks for loads of stuff in the baby check, and it is pretty important for spotting a variety of things).

If she really isn't going to get any medical checks, I would sit her down and say it. You might risk the friendship, but the baby's health is at risk, and in the end I think she will come round.

It is also possible that it could make her more reluctant to allow HCP's to see her child? Not that that is a reason not to tell her, but it might influence her.

This is a really difficult situation and I totally understand your worries. As difficult as it will be I agree you should try to talk to her about your concerns from the babys health point of view. If I had these suspicions, kept quiet and then something terrible happened I would never be able to forgive myself and that alone could very likely destroy the friendship. Surely if your friendship is strong enough and you are sensitive/tactful (which I'm sure you will be) then she can't be angry with you for raising your worries? Thats just my feelings anyway. Hope you manage to make a decision you feel comfortable with and your friendship and especially the babys health remain intact.

This is great guys thank you. You are mainly confirming that I do need to say something. She may hate me and throw me out the house, but at least I will have peace of mind. I may well be wrong but just get her checked out at least.

If she has a nursing background she must know that she needs to get her baby registered with a GP. She mut also be as aware as you are how to recognise DS. I wouldn't say anything yet anyway. If she does nothing about getting her baby checked out and you still think that the baby shows signs of DS in a few weeks then it maybe that you will have to bring up the subject.

If you feel quite certain, then its only fair to say something, very very tactfully.

TBH if I knew someone wasn't having basic checks done on a newborn I would call the HV and ask advice because I think it's a serious child protection issue. The child might not have DS but she could have some other avoidable but serious problem that would be picked up at a check. Your friend is really letting her child down by not having her looked at.

Why did your friend indulge herself in using a private midwife but she won't use a HV for the sake of her newborn?

I don't understand it.

Surely the baby cannot stay outside of ALL medical/social/public services, regardless of parental wishes?
I've never tried keeping a child away from "professional" care/intervention (so could be totally wrong), but I imagine that you HAVE to register the birth (legally) and that triggers other "intervention" regardless of parent wants it or not.

I would be v careful of suggesting the baby hasn't had access to medical services and that the parent has no idea if baby is "healthy" or not - it might come across to your friend that you're suggesting she's negligent or irresponsible. Whilst saying "my, he looks a bit Downs-Syndrome-y" would be beyond offensive.

I think your best approach is encouragement to get the normal 6-wk check at least (and preferably to get a medical check much sooner than that).

I would wait until 6 weeks, see if she goes for the 6 week check, the doctor should pick it up there, it's perfectly ok to refuse immunisation at that point (wrong, but you can do it) but it will raise concerns with SS if she wo'nt register her child with a GP.

If she doesn't go for the 6 week check, I'd encourage her to go saying it's the best way to stop social services bothering her is to at least let a doctor give her baby a once over and see she is fine. If her DD does have Down Syndrome and it's as obvious as you say, it'll be flagged up by the GP then. Or do you think you can't wait 3 more weeks?

I also had a pronounced DS look as a child, but still, I'd say something - frame it exactly as you did to us, in terms of fixable heart conditions.

I think in your shoes, I would try to ascertain if she will take the baby for the routine 6 week check before acting yourself. For if one is booked, and the signs are obvious, they will be picked up on then.

If not, then I agree you must find a way to voice your concerns. Can DH help? Which of you has the more clearly relevant medical expertise?

I would be more tempted to call the health visitor team for her area than to say something directly to her.

I worry about waiting if there is a heart problem. I agree a push for the check up is vital at this point.

My feeling is that if she has gone down the route of no intervention pre-natally and during the birth she is probably an intelligent woman who has made informed decisions. Is this true? If so then surely she'll be looking out for possible problems with the baby herself. I mean, who has a baby and presumes everything's OK? We either rely on the professionals (pre-natal testing and checks), midwives or we educate ourselves to do similar.

If I am completely wrong then it's likely that she won't listen to what your concerns are either. I can't understand why someone would want NO professional to check their newborn baby over - even just heart and skeletal problems. We are fortunate to live in a country where we have access to good medical care.

I really don't want to go behind her back though and contact HV. That seems a bit harsh.

Please please say something. She's clearly opted out of all tests so hasn't evn had basic heart screening. She need to know that 40-50% of downs babies have heart defects that cn be life threatening.

Is the baby unusually placid or floppy when you hold it? That would be a really worrying feature ..

A " who does baby look like? ....have you ever thought he looks a bit unusual" type of conversational opener might help. Voice your worries gently and wait for the tears anger etc but ultimately that baby doesn't ave anyone else looking out for it medically.( shakes head sadly at an intelligent woman wo hasn't even ad heel prick testing- for 3 conditions where treatment early and before symptoms happen hugely alters th health of the child long term- hypothyroidism , PKU and cf , I mean why would you not?)

Bonkers, she is an intelligent woman who just chooses to assume all is okay. I suspect she may have suspicions but just can not voice them yet. Why would you as a new mum!

Theas I know. Exactly why I feel I should say something. It's going to be really hard but I have to.

I think any intelligent woman would voice her suspicions to a doctor or HV if she thought there was something wrong with her newborn

colleague's daughter had 'facial and other' characteristics of downs. but when they saw the father, mother and baby together, everyone realised it wasn't the case.