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Honestly, it would be difficult for me to not want to report her for medical neglect. Reporting is done anonymously so they would never know it was you. If the baby's cheeks are sunken in/guant and has a general appearance of being weak or sickly I wouldn't hesitate to report.

@jh524: This could be a stretch, but do you know if her baby was tested for cystic fibrosis at birth with the heel prick? I'm not an expert in this at all, but the cough and the fact that she's not gaining weight or keeping food down are red flags to me that *could* potentially indicate CF. People with CF struggle to gain weight (due to their body's inability to absorb nutrients properly), and have a persistent cough that is quite mucusy - you said the baby has a cough, has it been around since birth or is it a new thing? More than likely it's not CF, but if she hasn't had the baby tested, I think it is definitely something to look into.... Could you ask her if she had the heel prick done?

@jh524: Its usually a heel prick thing where they check the baby's blood sugar like they would for adults. They usually do it right away for moms that had GD. I only ask because the baby was big and I wonder how closely mom was monitored in terms of prenatal care if she's so sketched out by doctors in general. As an example, my boss' son was born at 36 weeks and the baby was 8lbs. and mom had GD. The hospital checked his blood sugar multiple times a day. His blood sugar was low at birth and because it wouldn't hold stable without falling, they put him on formula right away and asked mom to pump - they couldn't trust that her colostrum or milk, whenever it came in, would do it fast enough to regulate his sugars. He was in NICU being monitored just for blood sugar for 5 days being discharged and my boss and his wife just decided to stay with formula to reduce stress on mom and keep his intake steady and stable.

That's very alarming to me! There is something really wrong for baby not to be gaining weight. Is she not growing by length either?

Just as another comparison, DS was 50% by weight for his first 6 months, and fell slightly to 40% thereafter, but his ped said that it was normal for breastfed babies to drop a bit somewhere bw 6 and 18 months, as they get more active. DS was an early crawler and pull-upper, so I wasn't concerned. He was 7 lbs 2 oz at birth and 13 lbs 12 oz at 3 months. He has been 85-90% for height all along.

I pulled up the WHO charts for you. Your friend's daughter has fallen to bw 2-5% at 3 mo, down from 90% at birth! Maybe numbers will sway her that there is, in fact, an issue?

http://www.cdc.gov/growthcharts/data/who/grchrt_girls_24lw_9210.pdf

I haven't read everything but I want to say if you are really concerned and she isn't responding to your help, call CPS. If they need to investigate they will, they can tell you if it's appropriate. Their goal is to keep families together so don't feel like CPS = taking baby away. DH and I are mandated reporters and is a child psychologist so he calls them daily. They are a good resource!

I would rather be that guy and say something vs watch something bad happen to the baby. You could be totally wrong and baby is fine, but at least you tried. Or you could be right and baby can get medical attention it needs.

Good luck over the next few days. We are all rooting for you and this sweet baby.

Wow - just reading all of this , I'm concerned for this baby. I hope we're all wrong but it definitely feels like something is going on here. Please keep us posted!

@jh524: I would talk to grandma unless you are really very close. Sounds like grandma both has concerns and knows more. It sounds like mama is on a situation where she is blocking out advice, so I wouldn't go with the direct approach . Talk to your husband and others involved but don't be the only one who says something. Maybe mama has PPD and isn't remembering to feed baby, maybe something more complex is going on.

@jh524: Still thinking of you and that baby and have been for days! My son is now just shy of 15 months and thriving but he was born at 6lb 15oz and was down to 6lbs 6at discharge because my milk wasn't coming in and he had jaundice. The doctors made us come in every 48 hours for like two weeks and I was BFing 24/7. My son never stopped crying and was puking everywhere. After 3 weeks we got him medicated for reflux (which ultimately required a few dosage adjustments and then a second drug that finally made a huge difference), started supplementing with formula, and eventually put him on a 3 hour feeding schedule on bottles of pumped milk and a bottle of formula at bedtime because his weight was still not going up as fast as doctors wanted and I wanted to verify the total amount he was eating every day. After 3 months of hard work he was about 12lbs (so just under double his birth weight) and he was at the 30th percentile for his curve. The ped wasn't worried anymore but told me to keep up whatever I was doing. At 1 year he was finally at 50% and my ped told me to relax, but that first year was me constantly worrying about his caloric intake, fattening up his solids with oil and butter, and spending upwards of 3 hours a day pumping until I weaned to formula. When I think about those early months when he was screaming and crying from hunger and reflux pains (he was on meds until 5.5 months) I feel so bad and so grateful he's okay. I really really hope however she gets help that this baby finds a solution soon. My son fought bottles and eating for months just because he associated it with pain and throwing up and being miserable, so he basically cried all the time - from hunger, then pain, then from throwing up, then from being hungry from throwing up, etc. I so feel for this baby! God bless you for being concerned!

@jh524: I'm not a social worker, but I have worked in the mental health field and as a teacher. I have students who were in some borderline abuse cases, and mostly the CPS worker would meet with them and lay out some rules about what the family had to do. It's not like CPS will come and just remove the baby right away (unless they believe she is imminent danger, in which case I hope they would). I would guess they would lay out some guidelines about how often she needs to take baby to the doctor, require proof, maybe even go on the doctor's visits with her. I hate thinking of this poor baby not getting enough food. It's so sad.

It's so hard to call. I was a mandated reporter, so I was required to do so, which kind of takes the question out of it. With family, it would be super hard, but something's gotta give.

@jh524: as a teacher who has had to call cps, I understand your hesitation. People often think that calling = child taken away. But that's not usually the case. They can assign a caseworker who can keep an eye on baby, help mom make a plan for medical care, and require her to follow through. There can be education for mom and other support services. Hope this helps you feel better about calling. It sounds like the right thing to do in this case.

@Chuckles: I agree with this. Really, there isn't much else you can do but call and report a concern for medical neglect. I know it's family, but like you said, you rarely see them and it doesn't seem like she is interested in having a dialogue about it. You'll never be named as a reporter and at least you would know you did what you could. If not you, would someone else in the family be more comfortable making the CPS call?

@jh524: Honestly, the more you talk about this, the more I feel like you need to call CPS. This baby needs someone to be in her corner and help to make sure that she gets the medical care that she needs and deserves. If her mom is not willing to do that on her own, then she needs somebody to force her to do so. CPS will do that and she will never know that it is you who reported her.

I'm REALLY not trying to be mean, I actually do feel for you and appreciate the predicament you're in. I'm just not sure that there's a gentle way to say this. But if you can live with yourself if something happens to that baby, then by all means just stand by. But I suspect that if something happened to that baby as a result of not calling (death or serious illness) you would feel remorse for the rest of your life. At this point, if the worst happens, it's not just the moms fault - it's the entire family's fault for not getting involved when they knew something was wrong. The mom is a big girl. She can take care of herself however she wants. But that baby deserves more. It sounds like she is suffering. She is helpless and the one person who is supposed to advocate for her is not. So it has to be someone else.

I get that it's hard to do. But getting a call that the baby died will be a lot harder in my opinion. The mom sounds completely inept. It actually hurts me to think about the pain this baby is in. Physically hurts my heart.

@SweetiePie: This. A thousand times this.

Please call.