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The United States lacks postpartum support for mothers

Rajka Milanovic Galbraith, MD
Patient
October 12, 2011
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Last month, vegan couple Jade Sanders and Lamont Thomas’ appeal of their life in prison sentence was overturned.  The couple reportedly starved their 6 week old to death by feeding him only soymilk and apple juice.  When reading this, so many questions arise. How could they not know their child was starving? Where was their support? Were they truly negligent?  And what happened to all the systems in place to protect children?

In an ideal world if a child is failing to thrive, someone should notice.  Having done deliveries for the first 6 years of my family practice, I had one memorable case of failure to thrive.   I ultimately admitted the infant who gained weight in the hospital.  She was not being fed properly.  In this case, a little education on not watering down formula went a long way.

But what if an infant is thriving at the 1-week and the 2-week visit?  The next visit might not happen until 2 months of age.  Where are our checks and balances?

Having lived as an expatriate 5 1/2 of the past 6 1/2 years, I can’t help but notice the many postpartum services available in other parts of the world are not universally available in the USA.  If they were available, they may have prevented this unnecessary death.  The operative word is “may.”

Let’s look at these postpartum services.  In the UK, there are “health visitors” that visit all mothers at home postpartum. Every family with children under five has a named health visitor. They offer support and encouragement to families and work closely with the family’s GP (UK’s equivalent to the Family Medicine Doctor) Recently with additional mental health training, these health visitors are helping prevent post partum depression.

In the New Zealand, they have Plunket, an organization that provides free support services for the development, health and well-being of children under five.  They make home visits, have a call line, provide parenting education and have a drop in center.  Any woman who simply needs a break can drop in and take a nap while her infant is watched.  I don’t know of a single mother who could not benefit from this service.

While in Australia they have Early Childhood Australia that provides support to children from birth to 8.  Community child health nurses do the first visit at home and then see the infant every 2 weeks until seen by their pediatrician.

It is true that the above-mentioned countries have socialized medicine.  But we must ask ourselves why should this matter?  Can’t we strive to be better in the USA and provide services universally to all mothers not just when a problem arises? Imagine how we all as mothers could have benefited… maybe not have struggled as much.

As a new mother of any socioeconomic status, there are challenges.  These challenges exist no matter how “textbook baby” your infant is, how well read on parenting you are or even if you are trained as a physician.

Our first-born was severely irritable from GER for the first 13 months of his life.  It was a vicious cycle of eat vomit cry.  We were helpless to help him.  Our GI specialist warned us of how draining it would be and to get help. Imagine if seeking help was readily available through an organization like Plunket.  Imagine how a mother would feel if she wasn’t made to feel like a failure from the start.

Rajka Milanovic Galbraith is a family physician who blogs at Expat Doctor Mom. 

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