Help! Need advice please!!

[mommyof2princesses]

Help! Need advice......I have a 15 month old dcg who absolutely has refused to eat/drink ANYTHING here since day 1 (same at home as well), she is strictly breastfed. This in turn has caused her to lose weight (she looks like a 6 month old) and at her doctor appointment this morning the pediatrician admitted her to hospital because of the weight loss, etc. I just got the text from mom to let me know, her brother is here today still. The pediatrician says he doesn't know if she will be in hospital for a few days or maybe even weeks Poor little thing. My question to you is would you still make them pay for the space? I assume the brother will still be here but that is yet to be determined, no idea what will happen now. And advice is appreciated, thank you!

[playfelt]

I had two in hospital this past winter for different reasons but I charged the family half fees for any day the child was in the actual hospital. It was for sure appreciated given the added stress at the time for them. In your case I would be far more lenient on my late fees for the brother in care offering to go the extra mile during the crisis phase. There are times when we have to put our business aside and become the humanitarian or at least that is how I feel.

If the brother is removed too then for sure it is full fee for the brother because there is no reason why he couldn't come (assuming you can be flexible on arrival time and pickup if it is a different person doing it or whatever while parents are at hospital). Then your choice on the child in hospital.

At the same time start investigating what care demands are in your area as there is a very good chance child will be out for a long time and then need specialized care afterwards. Being fitted for a feeding tube is one possibility for the child which would be beyond the scope of most home daycares and either child would be cared for in their home or in a daycare centre where a trained person would be coming to do the feeds. My point is you may suddenly find yourself needing to fill two spaces which is a good reason to get as much payment as you can now but I know I didn't feel right charging the full fee while the parents were taking off work to sit by their child's hospital bedside.

[mommyof2princesses]

That helps a lot playfelt, thank you!

[mommyof2princesses]

Thanks playfelt! Mom came tonight to pick up brother and handed me a cheque for the amount owed for the next two weeks without me even saying anything. Little one will be in hospital till at least Monday then they will decide what to do after that.

[mimi]

Hope this little one has a good recovery. You are a sweet person mommyof 2 to consider what this family is going through.

[mommyof2princesses]

Thanks mimi I am not too sure what's going to happen because apparently dr thinks that as soon as she feels better by pumping her full of nutrients/fluids she will want to eat. This little one has NEVER eaten, her being weak and loosing weight is because she doesn't eat and has never (only breastfed) so both dcm and I think that as soon as she is sent home give it a bit and its going to happen all over again I have no idea what to do as she is with me mondays to fridays 7:30 am to 4:30pm with not even so much as a sip of water!

[jammiesandtea]

I'm just curious, has the Dr. recommended that the mom wean the child from the breast, given that it isn't meeting her nutritional needs and seems to be preventing her from wanting to eat regular foods?

[playfelt]

I would think weaning would be part of the program - it will happen on it's own if child is in the hospital long enough because the mom won't be feeding. If she is pumping at the hospital as a supplement they will be able to see how much child is getting. There is a very good chance the mom is not producing enough milk and the child appears to be breastfeeding but is really only suckling for comfort for part of the time. Would be interesting to know how often child feeds evening/overnight.

They won't release her from the hospital until she is eating fully or they will fit her with an alternate feeding system. She may also be put on a supplement - think pediasure but one that has the increased nutrients she needs if she doesn't eat food. She will also be closely followed by a nutritionist and again won't be released from the hospital till they have done their workup. Which is why the doctor was saying days/weeks - she can't go home till she puts on the required weight and is eating enough to maintain that so I wouldn't worry about her falling into her old patterns.

They will also be doing blood work I would think to look for anomalies that could indicate a condition related to failure to thrive that is in part a cause for the eating and weight loss.

One thing you might want to do is ask for contact with the nutritionist since you will be responsible for a large part of the meals/snacks. What this will allow you to do is have a direct link and if child stops eating and you suspect the parent is not going to do anything about it I would contact the nutritionist or even the doctor and relay your concerns about the child. It is not something that can happen over and over. This is a very critical age for brain development and damage may already have been done which is one of the reasons she seems more like a baby than a toddler.

What is the brother like in terms of size, weight, development in the sense of is this an issue only with the girl or have you noticed anything unusual about the brother that might indicate a problem at home. Depending on the doctor and what comes out at the hospital there may be need for a social worker to be involved to monitor the child's well being once released and they may want to meet/talk with you too depending on the severity of the problem or what they think is the cause.

[mommyof2princesses]

I got a text from mom today saying that the doctors and nurses all want mom to stop breastfeeding (except for once before bed time) and tonight a feeding tube will be placed down little one's nose to give her half the calories she needs each day and then they are hoping she will get hungry enough to eat during the day. Normally mom breastfeeds her only 3 times a day - am, late afternoon and bed time, so there is no way this was enough for little one to sustain a healthy weight, etc.

If they are going to wait for her to eat normally and put on the proper weight she needs to and sustain all this I have a feeling she'll be in there for weeks Any time you put food in front of her she gets angry and throws it on the floor. She even did this at the hospital yesterday to a nurse mom told me.

Yes she had blood work and urine tests done yesterday.

Thanks playfelt, I will definitely get the doctor/nutritionist's numbers I am also prepared for a social worker to speak with me, I was wondering if that would happen.

The brother is of normal size, like any 3 year old. He eats anything and drinks regularly since day 1. I have had him since he was 12 months old.

Thanks for your input everyone, it's really helpful!