My wife noticed 2 days ago that our 6 day old newborn baby girl wasn't really moving her left arm properly and appeared to be in pain when we changed her shirt or moved her arm around. We therefore made an appointment with a primary care pediatrician to get it checked out. The primary care physician suggested that she may have fractured her clavicle during birth (which is apparently common), so we should go to the emergency room at our local children's hospital to get some imaging done.
We went directly to the emergency room, and they admitted us and suggested she get an x ray. From the start we expressed our concerns about exposing her to radiation at such a young age, but agreed to get an x ray on her left arm/shoulder, and it came back with the result that there is healing happening in her humerus at her elbow (I forget the medical terminology), potentially a fracture, infection, or some other acute injury. My wife and I are unsure how the injury could have happened (the only logical explanation is it was an injury during delivery, but wasn't identified over the first several days).
The doctors described the injury as a high risk, highly uncommon injury consistent with a baby being handled roughly, and they put us in their protocol to examine if there was child abuse involved, which would mean getting x rays of her whole body to rule out further injuries and maybe even a head CT scan.
In the meantime, an orthopedic surgeon examined our daughter and said she has no concerns for underlying bone disease, but was concerned about this high risk injury with no clear reason for how it happened.
We explained that abuse and rough handling is not possible, as we are the only ones caring for the baby, have not handled her roughly. We also have 2 daughters (ages 4 and 7), and the doctors asked if they could have handled her - while they have held her twice each, it was under our supervision and nothing out of the ordinary happened. The only other people who have touched her are medical professionals. My wife and I have no idea how the injury could have happened. We haven't intentionally or accidentally caused her any harm, and believe abuse/mishandling is impossible.
The only logical explanations are that it happened during birth or that it happened while she was nursing, but the 2nd seems highly unlikely as we can't think of any position that could have injured her.
They wanted to do 20 x rays all over her body (a full bone scan) and we expressed serious concerns about exposing her to unnecessary radiation at such a young age, especially since the issue causing her pain (her left arm) had already been identified and there was no clear need for the bone scan x rays other than to rule out further injury due to abuse, which as parents we are sure has not happened.
After lots of back and forth and doing some blood work, the doctor informed us that they would report us to Child Protective Services for medical negligence if we refused the x rays. We asked to speak to a social worker, who explained what would happen with CPS if we refused, such as that they would enter our home and do an investigation to determine if any abuse had happened (we again stated to the social worker that any abuse was impossible).
Keep in mind how stressful this whole situation was - at this point it was ~3am, we were sleep deprived, our 2 older daughters were sleeping on the exam table in the hospital room, and none of us had eaten since 1pm the day before.
Long story short, we finally agreed to the x rays, and they did 20 x rays of our 6 day old baby. I was in the room for the x rays - it wasn't fun. Everyone involved reassured us that it was safe and wouldn't have negative health effects for our baby, but it was scary. They did use protective blankets for some of the x rays but not all.
All of the x rays came back negative (except the left elbow which had already been identified). The doctor then informed us that no further tests would be necessary. She explained that the injury likely happened during delivery and discharged us. There is essentially nothing we can do for the left arm except let it heal. They still reported the case to CPS, with the justification that it is a highly unusual injury for a 6 day old newborn.
I totally understand the hospital's legal obligations to examine potential cases of child abuse, but never thought that this is how it would go down, and we are super frustrated that nobody believed that our baby hadn't been abused without seeing the x rays. The whole thing seemed like they were doing these x rays for compliance with hospital policies around child abuse, not for any real clinical need that would help get to the bottom of what was causing her arm discomfort. We explained so many times that we want to get to the bottom of it but would prefer alternative diagnostics that don't use radiation - they offered none.
We understand that x rays are low risk, but 20 seems like a lot for a 6 day old baby and my wife is super worried about the potential future cancer risk for our baby.
Two questions:
Is there any risk to our baby of having been exposed to so many x rays?
other than ruling out further injuries due to child abuse, why would they even need to do so many x rays? I just don't understand how x rays of a baby's right foot, for instance, is medically necessary to treat a left elbow injury