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Another rickets tragedy

Posted on: January 19, 2012   by  John Cannell, MD

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I received the following email this morning and these cases continue to break my heart. I have been conversing over the phone with this mother, Deborah, all day. While I do not definitively know if Deborah and her fiancé are innocent, my belief is that they are – I have heard and seen far too many similar cases.

Dear Dr. Cannell: 

We spoke on the phone earlier today about the situation that I’m in. My fiancé and I are in the process of one of us being convicted of child abuse. My son Jason is 2 months old. I’m African American as well as my fiancé. I breast fed my baby but did not give him vitamin D supplements. The baby doctor said nothing about vitamin D. I attend college, so my fiancé took time off (from school) to help raise our son. Jason was born 11/19/11, and we live in PA (it’s very cold where we live). We do not take our son outside because I fear he would catch a cold.

The night before we took our son to the hospital, I had gone to class and my fiancé was watching him; he would never hit Jason. He has a daughter prior to our son and no history of abuse with her. So my son was crying and I came back, he was trying to calm him down by walking around the apartment, which was one of the techniques I showed him to calm our son down when he twitches and cries. Then he began to twitch worse and we called the pediatrician like we always do, and she told us to monitor him and he should be fine. Well the twitching didn’t go away and my fiancé called the pediatrician again to tell her it didn’t stop. She then told us to come in, that it could be something else.

We brought him in, and he was not twitching at the doctor’s office, so they directed us to the hospital. Jason started twitching again. So they took him and told us to wait, they wanted to do a CT scan of his head. The doctor came back telling us that he had suffered severe head trauma and may have brain injuries. We were shocked and started crying all over the hospital, trying to get in touch with our parents to tell them this horrible news. Jason had to be transported to a children’s hospital where they then informed us that he has multiple fractures of the head, ribs, leg, and collar bone. We had NO IDEA how that happened. We were always careful.

The police then talked to us, as well as child services. They wanted me to testify against my fiancé, but I couldn’t because it didn’t make sense. There were no signs of abuse. He had no bruises, nothing! They said some of the fractures appeared to be old but again, there were no signs. The old fractures were from when Jason was in my care, and I would never abuse my son. His father was rarely around then as he was working two jobs. Just the past week is when he began to watch Jason by himself. Therefore, the fractures, I have no idea where they have come from. My parents didn’t see it, the doctors, the hospital. Nobody saw any bruises or signs of child abuse. We were going to the hospital regularly too.

I then remembered that one of the hospital blood tests he had undergone about 4 weeks ago showed that he had very low vitamin D levels. We got it retested; the second time my son was taking Vit-D-Sol, but the test again showed his vitamin D levels were still very low.

I read all over online about what could be the cause. I came across your website and article. His legs curve but the doctors told me not to worry, it’s nothing. But after reading and learning about rickets, I believe that my son may have this. Can you please help me! I’m being threatened that they will remove my child and not even give Jason to my parents unless I testify against my fiancé. I need your help.

Thank you. If you need me to do anything, let me know. Thanks for your help,

Deborah

Dear Deborah:

I can only try to understand the tragedy that you are going through. If this had happened five years ago, you would have had no chance. Either you send your man to prison or you lose your baby. However, things are starting to change. I can try to help.

The twitching you noticed in your son are probably small seizures from episodic low blood calcium; it sounds as if he has had this for a while. Given time, the baby formula Jason is now on will treat these. However, the doctors are giving your son inadequate amounts of vitamin D, that is why his second vitamin D level did not go up. Also, ask them to do an “alkaline phosphatase bone” blood test and x-rays of the ankle and wrist as soon as possible and send the doctors the request for these tests in a registered letter. How low was his vitamin D, do you remember? The fact that you have a vitamin D level before they took the baby away is incredibly important. Also, bowed legs, like your son has, are very common in rickets.

The lack of bruises over the fractures is typical with rickets. Trauma, such as hitting, causes bruises; rickets seldom does. Also, if someone was repeatedly beating the infant, the infant would often cry when that person picked him up or came close. Sometimes mothers hear “popping” noises as the rachitic infants’ bones softly break on normal handling or changing. Have you ever heard such noises?

Jason will heal now as he is on infant formula, which contains lots of vitamin D for his 10 pounds of body weight. However, they will say he healed because he is out of your abusive household. As I understand it, your fiancé was not around during the time of the old fractures, so he could not have done them. If someone had hit Jason in the last week, bruises would have been evident to you.

The “severe head trauma” is bleeding on the surface of the brain, which is common in these cases, and again, no bruises will be found. One of the email addresses that I am going to give you is Mr. Zach Bravos, a lawyer and an expert in this field of “head trauma” and abuse. His paper on the subject will help your attorney.

They will try to get you to testify against your fiancé in order to keep your baby. It is a terrible choice, a Sophie’s Choice, but I advise you to stay on the side of truth and let your man know that you will. Your fiancé needs help; tell him these false accusations are common, especially among Black couples who breast-fed their infants. He needs to know that you support him. Tell him there are others in his shoes. He needs professional help if he is suicidal.

The second person that may help your attorney is Dr. David Ayoub, a radiologist very familiar with these cases. I will call you and give you Dr. Ayoub’s information.

Please stay in touch and do not give up hope.

John Cannell, MD

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