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Original poster

Can you refuse to have your baby admitted to special care? Can they force you?

74 replies

IlanaK · 28/07/2008 20:33

Quick story: my baby was born last monday. Within a few hours, he was admitted to the neonatal intensive care as he was having breathing problems. He has been on special care since then until we finally convinced them to discharge us today. The breathing issues resolved a couple of days ago, but he was kept there due to needing iv antibiotics. While there, his bilirubin levels were checked as he was a little jaundiced. He ended up needing phototherapy on and off. His levels finally came down low enough today to take him home, but a final blood test result shows they are rising a little again. We are due to return for another blood test tomorow afternoon.

I DO NOT want him readmitted. I said to the doctor on the phone today that I would come in for the blood test and if she felt he needed further phototherapy I would stay for the 6 hours there with him then take him home. I would return if a further blood test was needed. She would not committ to agreeing this. Can I refuse to have him readmitted? Can they force me or am I within my rights to decide this as a parent?

Any help really appreciated.

OP posts:
CuckooClockWise · 28/07/2008 20:35

WEll, I don't know, but I don't understand your reluctance. I think that with such pressure on beds they'd only keep him overnight if they thought it was necessary.

My own baby was born at 36 wks and was in something called transitionary care (I think) for 3 nights. I was happy for him to be there.

Original poster
IlanaK · 28/07/2008 20:37

I have lots of reasons for not wanting him there. I also feel (with full knowledge of all the details of his care) that he does not need to be there overnight. Phototherapy can be done at home. I can return to hospital for it if needed as a day case. He does not need to be there overnight.

Does anyone know if they can insist?

OP posts:
tiggerlovestobounce · 28/07/2008 20:38

If you refuse, and they feel it is really needed and they cant persuade you then they will have to apply to have your baby put under the care of the court so that decisions can be made by the judge in the babies best interests. I dont know how likely or not that would be.
Most doctors would try to avoid conflict like this, but if they feel that your baby is at serious risk they would have no choice. hopefully it shouldnt come to that.
If they are so keen to have your baby in hospital then hopefully they have explained the reasoning for this to you, if not then get them to talk about the risks of not being treated vs what would happen if he is treated.

nervousal · 28/07/2008 20:38

I think that they might be able to over rule if they think that your child is in danger. Like cuckoo says they'll only readmit if necessary? If he can have phototherapy as an outpatient then I'm sure they would agree to this.

SparklyGothKat · 28/07/2008 20:40

why would you refuse? I asked what weight my DS2 would have to be to not be taken to SCBU i was told that a 33 weeker would have to go to SCBU (I was hoping he wouldn't have to lol) He weighed more than my DD2 did when she came home (born at 33 weeks too) but was taken to SCBU anyway.

If he needs to be in SCBU then you should take him, Jaudice can be nasty.

PictureThis · 28/07/2008 20:41

Why would you refuse to have your child admitted to special care if the doctors felt it was an appropriate treatment?

traceybath · 28/07/2008 20:41

I suspect that they can't force you but they may decide to contact social services or something if they felt your baby really should be in nicu.

My baby was in nicu for a week and conditions of our discharge were to see midwife/hv very regularly for weigh ins. He had breathing difficulties and poor weight gain.

As the others have said though am sure they'd only want to admit if necessary.

girliefriend · 28/07/2008 20:41

hello yes they can make your baby go in if it is in the childs best interests. I was deserate to take my dd home when she was admited to special care under very similar circumstances. I checked out my rights with a friend who works in neonatal care only to discover that I have none! Very scary really, the only thing they consulted me on was whether or not to give my dd a dummy (not whether or not it was okay to do a lumber puncture on her!) Hope your babe is o.kay XxX

Original poster
IlanaK · 28/07/2008 20:41

Thanks. SUrely as there are other options and I am not refusing to have him treated (just not to have him readmitted), they would not actually go to court.

OP posts:
Kewcumber · 28/07/2008 20:43

They don;t give away places in special care wihout good reason. I wouldn't turn it down. And without wanting to sound paranoid, I'm not sure I would want to have on his notes that I refused to let my baby be admitted to special care.

PerkinWarbeck · 28/07/2008 20:43

legal position is that the doctors would have to liaise closely with you to agree an acceptable compromise. if you were refusing treatment to the extent that this would have serious consequences for your child's health they will contact the trust solicitors for a court order.

Twinkie1 · 28/07/2008 20:43

Sorry I don;t get it?

If they want him there for his own good and the treatment to make him better why wiuld you as his mother not go along with that?

If I were a doctor I would think it very suspect that a mother was not doing what I had told her was best for her newborn!

PictureThis · 28/07/2008 20:44

I have not heard of phototherapy being done at home either.

lou031205 · 28/07/2008 20:44

I compromised with my hospital re:jaundice. I took DD2 in for a blood test in the morning, and then stayed overnight with her (they provided me with a room). The next evening, I was discharged, and agreed to bring her in to the ward for a further blood test the next morning. We did this three or four times over the course of a week. The other thing you could ask for is that you room in with your DS and have a billibed for him, it is a unit that fits in the cot with a velcro sleeping bag he lies in.

tiggerlovestobounce · 28/07/2008 20:44

Unless they thought that the observation and monitoring that admission would allow was very important.
I'm sure going to court would be an absolute last resort.

Original poster
IlanaK · 28/07/2008 20:45

Just to clarify - I am NOT refusing him treatment. He has been there for a week intitially for very good reasons - breathing problems on birth. (He was full term by the way). These are completely resolved - it even says so on his notes. The only outstanding issue is jaundice. I feel that this is physiological jaundice - he is a fully breastfed baby. He is totally well in all other ways - no problems with weight gain or anything. The doctors have all agreed and that is why they agreed to discharge today. IF his levels are up again tomorow after a blood test, I have no objection to phototherapy. I just want it done in the day with me there or at home. NOT to have him readmitted.

OP posts:
Kewcumber · 28/07/2008 20:46

but presumably they will do their best not to admit him? They're presumably not going to admit him on a whim.

fishie · 28/07/2008 20:47

ilana how awful for you, it must be so upsetting for you all

why don't you want him to be there, is it feeding? worries about hospital generally? infections?

DontNeedAnything · 28/07/2008 20:47

IlanaK.

I agree with others. Jaundice can be serious. Everyone else has said alll the important stuff Re what might/could happen in hte case of a conflict.

Are you putting him near a window, with just a vest on. Exposing him to natural sunlight will help keep his bilirubin levels down and could be a practical way to try an avoid a conflict.

tiggerlovestobounce · 28/07/2008 20:48

They wont try to readmit him unless they think he needs it. There arent nearly enough SCBU beds for that sort of thing.

traceybath · 28/07/2008 20:48

Will they actually do phototherapy at home though? Everyone i know has had to have it done in hospital?

lou031205 · 28/07/2008 20:49

For me, what enabled our compromise was partly that as a former nicu nurse (although briefly), I was totally aware of the signs of jaundice (in fact it was me who pointed out the jaundice to my midwife in hospital. She said it was the lights, but a blood test confirmed). I also was able to chat the consultant on the ward round, and asked whether in the absence of any clinical signs, if they weren't planning phototherapy overnight, but were going to test her blood in the morning, was there any clinical need for her presence in hospital overnight. He agreed that there wasn't.

Sidge · 28/07/2008 20:49

As SCBU beds are like gold dust (and cost thousands per day to staff and run) I would imagine they would only admit him if they felt it was necessary. And if it is medically necessary then they can seek an emergency court order to treat and keep him in without your consent. However I imagine they would do that as a last resort.

I really don't understand why you wouldn't want him kept overnight if it was necessary for his health? Home phototherapy isn't something that can be set up in an afternoon, and jaundice treatment is more than just zapping them with a bit of UV.

I think you should request a meeting with his consultant if you feel you are at odds with what the medical professionals want for him.

cafebistro · 28/07/2008 20:50

I dont understand your reasons for not having your baby readmitted. As long as your baby needs medical care then you should really follow the advice of the professionals. I understand that it must be very upsetting for you but the doctors are only doing whats best for your baby.
I thought phototherapy worked best when given constantly ( except feeding and nappy changes), so your babys billirubin levels are more likely to decrease faster if your baby stays under the lights overnight.

TheMadHouse · 28/07/2008 20:50

IlanaK. They will insist of you seeing a member of the phyh team for an eveluation.

A high Billiruben level might mean that it is not just jaundace, they may want to monitor again after the therapy. Surley one additional night in the space of a lifetime is worth it?

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