To challenge doctors decision re baby's care?

[codenameduchess]

DS was born Monday, has been in scbu since but released earlier today. Plan was we'd be on post natal ward while he has some light therapy for jaundice and then go home when we had the all clear from that.

All other tests have come back clear- he'd had RDS but breathing fine now, blood tests show no infection, blood gasses fine. Tonight his nurse has asked 4 doctors for a decision on if the antibiotics he'd been on could stop (given on day 1 as a 'just in case', never any infection markers or signs of infection seen). 3 refused to comment and one has said to carry on with IV antibiotics 2x a day for 7 full days, so ending Monday evening with a view to discharge Tuesday (probably Wednesday because they are soooo slow).
Now, I feel like this is a waste of time and resources, his nurse agrees. Why does a patient with no infection and no signs of infection need more antibiotics? As his mother do I not get to be involved in that discussion?

WIBU to say I do not think he needs these antibiotics or to stay in hospital taking up a needed bed for that much longer when really we could go home now.
Or request a non-IV option that we can give him at home/return to hospital for the doses as we both drive and live nearby.

I know it's caution because he's newborn, but he's never had an infection and the doctors have said that so why is he on medication to treat something that was never there?

As a mother you get to say what you will consent to and what you wont. Ask to speak to the doctor to discuss your concerns.

Suspected sepsis is still treated as sepsis

He should finish the course of antibiotics that was started.

My guess is that the antibiotics are a preventative measure. Getting an infection whilst in hospital is common, and given your baby's health issues and being so little, the doctors want to try and prevent him from catching any possible infection.

I think you should be asking PALS why the doctors have not bothered to discuss this with you. Because they should have! Once they've fulfilled their obligations and discussed it with you properly you probably won't have these questions.

I'm sorry your baby is being treated by such shit doctors.

Because of their educational background and the fact babies can become critically ill very very quickly. Accept that the additional care is in the babies best interest.

Usually I would say you are the mother so the final decision is down to you (and I think that’s the case) but I also believe a hospital is within its legal rights not to discharge the baby (they can’t keep you there), and if you try to remove the baby they can escalate to SS.

Has no doctor discussed the reasoning with you?

I understand your frustration, no one wants to be stuck in hospital longer than necessary and precautionary antiBs are a PITA. Deffo try to talk to a doctor again about an earlier discharge if it’s just about the antiBs and they don’t want to monitor either of you. I’m not sure if it’s possible to get non iv antiBs for a newborn though? I wouldn’t have thought they would prescribe anything like the yellow amoxicillin for a baby so little, plus you might have a hard job getting it down them!

And congratulations btw

One of my twins was admitted to hospital and put on IV antibiotics for a v.high white blood cell count no infection markers. Once the blood cell results returned to normal I thought he would stop the antibiotics but the consultant was very clear he had to do the full course because they suspected a serious infection, better safe and all that.
Congratulations on your little one

I had sort of the opposite experience. I knew there was something wrong with my 3 week old and they kept blaming it on insufficient milk supply. I refused to take him home when they tried to discharge us. He had no temp or infection markers, bloods all clear. The day after they tried to send us home (day 7 of being admitted) finally they found the infection. By this point he had lost so much weight it was terrifying. They finally started antibiotics but we were able to go home with a cannula and they came out once a day to do it. So in my experience better safe than sorry!

DS had suspected meningitis aged 1 and was on IV antibiotics twice a day, sadly one was 2 am as he'd been admitted then but we therefore took him home in the morning when he was perky enough to resist the drip, and brought him back for the 2 pm dose and again for bed.

Congratulations! Personally, I wouldn't make waves on this one, though I understand the frustration. I might ask someone (nicely!) to explain what the recommendation is and why. I might even ask for a second opinion, but that's as far as I'd go.

Ask to speak to the doctor who has had many more years specialist training than the very skilled nurse. I think it was unprofessional of the nurse to give her opinion, tbh, as it is making you doubt the care your child is getting. She has appropirate channels to raise concerns if she has them.

Go to the horses mouth, so to speak, and discuss your concerns with the doctor.

Thing is proving the cautious option wrong is betting on some pretty dire consequences.

I truly understand the desire to get home, I discharged myself against advice after giving birth but that was for my health not my dd’s and I’m able to communicate any signs of feeling ill, but I don’t think I’d be able to relax if I knew a doctor thought my baby should still be under close observation.

@youhavewonaprize you can get oral - it’s just given in a syringe.

OP, I’d definitely ask questions for your own peace of mind and if you get clear answers- trust their judgement. That’s what I think I’d do in that situation.

Hope all works out for you and congratulations on your little one.

"Shit doctors" ?

Sounds like their communication could be a bit better but "shit doctors" ? Give over. Maybe op should have removed her baby from NICU if they are so shit.

Definitely should carry on with anti biotics !!

There is some truly shocking "advice" on here sometimes.

I’m not sure if it’s possible to get non iv antiBs for a newborn though?

It definitely is. Dd was on prophylactic ab’s for an enlarged kidney for her first three months.

IV ab’s are better for an active infection though.

Communicating with patients about the care you want them to receive isn't fucking optional. It's not an optional extra to be grateful for, it's an integral part of medical care. How about they comply with their legal and ethical obligations if they don't want to be described as shit doctors?

Because they are shit doctors for not doing so. Attitudes like yours are the reason women's consent is still trampled all over in medical care without meaningful consequences for those concerned.

Give over yourself.

I said their communication could be better but calling them "shit doctors" implies the whole of their care is wrong.

And this is why we lose so many good health staff.

Congrats on your little one OP.

Usually they have bloods taken after 48h - were these done? Have you been made aware of the result? See if your midwife can get the doctor to come see you, you absolutely should be involved in the decision making.

Being in hospital isn’t easy and I imagine you just want him to come home!

I was on you other thread @codenameduchess

So glad you have left SCBU now.

FWIW when DC3 had her stint in Neonatal they did stop the AB immediately upon blood results confirming no infection.

However things may have changed? They may now have guidelines to give full dosage?

You have been I'll informed so you do need a Dr to come and explain to you.

I know you are keen to get home but for the sake of a few more days, you may just need to suck it up? (In the nicest possible way)

It will all be a distant memory soon.

@codenameduchess

Congratulations anyway . If I had a choice of "slightly ill baby" in hospital or at home I'd choose hospital any time.

Most of the time "Doctor does know best"

The only thing I would add is that iv antibiotics are preferable to oral as straight into the bloodstream means you know it’s targeting the desired bacteria. Anything given orally runs the risk of not making it to the desired zone.

Has he had his blood cultures done? They should only take 2 days and that will confirm if it’s sepsis or not.
I was in the same position 2 weeks ago with our new baby, nobody came to talk to us about what the cultures were for and we were very sleep deprived. Everybody was unbelievably slow and gave vague answers.
Our results actually took 3 days as the lab hadn’t ‘posted’ the results.
Our child’s full dosage was 3 days on two different antibiotics, I’d be questioning what the 7 day course is for.
I’m so glad you’re out of SBCU and I hope you and your baby will be out of there very soon.