Boy living off cow’s milk required emergency transfusions in hospital, court hears

Nurse says she had never seen a child with such low levels of haemoglobin

A three-year-old boy, who fed only on cow’s milk, required emergency blood and iron transfusions when admitted to hospital, a child care court hearing has heard.

The boy, who cannot be identified, has been in hospital for more than seven weeks, having been admitted with a tooth abscess and severely low levels of haemoglobin.

Tusla, the child and family agency, is seeking interim care orders for the boy and his younger sister, as well as supervision orders for the other children in the large family.

The court heard on Thursday that the mother and father, who are separated, are objecting to an interim care order for their youngest daughter.

READ MORE

A clinical nurse manager at the hospital told a court hearing that she had not seen a child with such low levels of haemoglobin in her 40-year career. The extent of his stomach swelling due to anaemia or malnourishment was also something she had never before observed.

The boy was “extremely ill” and given an emergency blood transfusion and six iron transfusions, she said. He was also “severely” constipated and still wearing nappies.

Initially his breathing and heart rate were increased, signalling his “system was struggling to keep him going”. There were “absolutely” concerns for his life, she said, and doctors wanted to assess his younger sibling for fear she was similarly suffering.

Since admission, he has been consuming high-calorie drinks and his eating is improving, she said. She has concerns his parents “are not able to meet his basic care needs”, such as ensuring he is properly fed, cleaned and toilet trained.

‘Malnourished’

On behalf of the guardian who was assigned by the court to all of the children earlier this week, a solicitor noted the boy’s mother had initially refused to give consent for an X-ray he needed. The mother felt his health had deteriorated while in hospital and she wanted him to be discharged against medical advice, the solicitor told the court.

A local public health nurse told the court the boy and his younger sister “looked malnourished” when she conducted a development assessment on April 8th. The mother informed her they drank full-fat cow’s milk from bottles, but the girl also ate “little bits now and again”, including Coco Pops. She said she couldn’t get the boy to eat “at all”.

Following the assessment she immediately contacted the family’s social worker and a doctor. The family was given three months to follow its care plan and ensure the children were medically assessed, but the boy was admitted to hospital within that period, having not visited a GP as directed, the nurse said.

A social worker assigned to the case last December said the family has been known to the service since 2010. She said engaging with the family was “challenging”, as the parents did not consent for her to see the children until a supervision order was issued in March.

There had been referrals to Tusla due to concerns over domestic violence and child neglect, she said, and she was worried the children were exposed to drug abuse and domestic violence between their parents. The father disclosed to her on July 8th that he wanted to attend a methadone programme, admitting he had taken heroin in recent weeks. He also alleged the mother used cocaine, she said.

The solicitor for the mother said her client recognises the need for “consistent feeding” of the boy. She does not want to negatively affect her other children, which is why she is not objecting to an interim care order if he were to be returned in September.

The woman is “vulnerable and very overwhelmed”, but recently she has been helped by local mothers and family members. It is the mother’s evidence that she is a victim of domestic violence and her husband is a drug user whom she has a barring order against, the solicitor said.

Representing the father, a solicitor said his client is committed to engaging in therapies. He is not residing in the family home but he wishes to be as “supportive as possible” to his children. The case continues on Friday.

Ellen O'Riordan

Ellen O'Riordan

Ellen O'Riordan is an Irish Times reporter