Guthrie Testing

QUESTION

Dear Midwife,
Hi there, . I've recently given birth to my 5th baby and today he had his heel prick. Having 5 of course makes me no expert, but I'm concerned the midwife who did the heel prick tried too forcefully to get blood.

I'm of course taking action in making sure my sons foot is ok, but it is bruised quite badly from his ankle right down to his toes, the underside of his foot also. This was also a return on the foot as initially he would not bleed from it thus she switched to the other foot and then switching back again to the right foot which had grown to around 2 times bigger than the left one - As I say, he's being treated for this. I realize sometimes it is hard to get the appropriate sample but never have I seen such brutality (strong word but fully intended!)

So, my question is, Is this a "normal" occurrence for getting the sample correct? Or was this 1 incident that perhaps was too forceful? Is there a point in which you should simply say "That is enough".

I enclose 2 photographs of his right foot - One taken 20 minutes after this and one taken an hour later. As you can see the swelling was quite horrific (or at least I thought so).

Many Thanks
E. Wilson.

ANSWER

It is hard for me to tell from the pictures exactly what happened. As long as there are no broken bones and the baby seems to be moving his feet normally and it goes away in a week-10 days, I wouldn't worry about it too much.

It's true that it is sometimes VERY difficult to get a sample in the quantity required, and since I wasn't there, it is impossible for me to tell if it was done too vigorously.

P.S. congratulations on the birth of your baby!

-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.