my day in public health....

ok, so i thought a lot about my middle child today.........mostly because i saw a baby this morning that was nearly as yellow as my middle baby was about the time he came home from the hospital, and it gave me the confidence to address this issue with a 15 year-old mamma and her know-it-all 30-something meanmamma.....the discourse went something like this........is the jaundice improving since you've been home.....?.....have the billirubin tests improved?.......'this baby doesn't have no jaundice......she isn't yellow...that's just her skin reflecting the yellow outfit and her yellow blanket........hmmm.....are you sure, that baby looks really yellow to me....let me get a nurse to take a look at her........the nurse i chose used to work ob....and took control of the conversation from the get-go.....she pressed her thumb into the baby's arm.....and said to the grandma....when i press in and release, her skin stays yellow....this baby is much to jaundiced for a 5-day old to ignore...let me go ahead and call your pediatrician to get her in asap.......after the nurse left the grandma said......well....i guess grannie was right when she said she thought that the baby was yeller.....i guess we should have believed her.......and then grandma (15 to 20 years younger than me) says to me.....what can happen to yeller babies?.......the pat answer is.....well, they can get brain damage from the build-up of the billirubin........what i didn't say is.....or they can grow up and go to princeton.........gentle readers, i was more disturbed by the fact that the actuall mamma, age 15, never touched that baby while they were in my office....any attention paid to it was by grandma......and when i asked the required family planning questions, grandma shut down that conversation right away with the predictable answer.....we don't have to worry about that happening anymore.......sadly, the next client to come in...not my client......was a 13-year-old's urine specimen for a pregnancy test.........no actual client...just the testable body fluid.......apparantly the health department has an arrangement with a crisis pregnancy center for such a service........the test was negative, and i will admit to having mixed feelings about the entire transaction....yes, privacy was insured, but who is proctecting this child against further unprotected and illegal sexual contact?........will this child have negative tests up and until she gets pregnant...only to become yet another underage mother, whose own mamma is raising her child for her........?