Extended Nursing Support Thread part 4

[katyusha]

On and off with BT feed here. He takes a formula as well. I have switiched to underwired normal bras and M is a bit dissapointed when he realises there is not that much there. The other day he went off with a bra going, 'milk!' I roll my eyes and try not to laugh.

[clazzat]

The hv's really are dreadful, Ali. I am constantly amazed at the advice that they give which flies in the face of common sense, let alone worldwide guidelines. Just because she doesn't come across mothers who feed for that long doesn't mean that she should be trying to discourage the ones that do.

I am wondering if we are starting to reach the end of bt feed with x, though - he doesn't seem as interested as he used to be so I think we might move on from it soon. I will be sad, though, so I am not rushing to it.

[katyusha]

Heard the same from HV for both kids.
Thing is my HV is lovely, so I would not want to offend. However She is good 15+ years older than me and back then the formula was the norm. So in a way even though they have heard the guidance it is not part of their inner belief. They think BFng past certain age wierd (1 y for sure) and even before that would suggest dropping it if there are any problems. By problems I mean Mum not getting enough sleep, baby dropping off the centile (imagine when we used older formula charts as well), baby bopping on and off the  breast, etc. GPs similarly believe that past 6 months and certainly past 1 year there are no imummological benefits. Around 6-8 momths HVs are worried that the babies who nurse are Not getting enough solids and that their weaning onto solids might be affected. Then any weaning difficulties (say teething, or a bug, so kid eats less) will lead to discussion on appropriateness of BF. Equally other things blamed on BF are: baby is dependent on mother, separation anxiety, how will he/she transition to nursery, and night wakings.
Any wonder then that women give up. Here if I say that they give uo for lack of support I would be accused of being prejudiced. Many women who formula feed say that they feel judged and that on the contrary they feel that 'breast is best' message from health proffessionals made them feel inadequate and nearly bullied into BF.

My view is that in the first instance we need to accept that as human species we process information easier in simplified terms, hence the gravitation towards simple messages which sadly end up marginalising people. Hence the coined slogans, steriotypes, and ready made judgements. Secondly, accurate info is IMO best. Accurate information without bias. Let the mum decide. Then whatever she decided, that is what goes and needs to be supported. The guilt or constant second guessing is very unhelpful and undermining, however well intentioned. IMO women who actually go to see HV have their child's best interest at heart and often already have thought through a few things.

As for feeding for own comfort - I have heard that a bit and I think of it as both judgemental and a form of emotional manipulation.

[amayzie]

PMG Ali- just read this!! Awful!! How many feeds are you doing anyway? It sounds that even if i'd suggested the 2 feeds i'm doing she'd have suggested that i was a boob waving hippy IT's just crazy! If i were you I'd try to complain or something.. that is completely inappropriate!!

The feeding for your own comfort thing!! That is just rude and must have made you feel like a mother BFing till 8!! HE"S ONE!!! ONE!!! (I wanted LARGER capitals for the second 'one' to highlight it further...)

[*Ali*]

Katy I told her I was feeding 4x but sometimes it's actually 5 if he is up in the middle of the night.
That's what is holding me back complaining. I don't think she was being unkind, she was perfectly pleasant but just extremely misguided. And like I say she isn't the only one.
The funny thing is I'm pretty sure this particular HV grew up and lived until quite recently in a developing country in Africa so I would have thought BFing and even extended BFing was more the norm there than it is in the UK so her mindset would be less biased by the formula years.

[Papaya]

Oh my goodness Ali, I am just seeing this now too. I would be fuming. In fact, I AM fuming! At that age F was having 3 feeds a day and sometimes a night feed or two when teething or sick. I would have been so mad if I'd been told by a health professional that there was anything wrong with that.

That's what is holding me back complaining. I don't think she was being unkind, she was perfectly pleasant but just extremely misguided. And like I say she isn't the only one.

See, this is PRECISELY what would make me complain - or perhaps complain isn't the right word, but raise my concerns with someone. If she is pleasant and friendly and comes across as though she's genuinely  giving the best advice, then less educated mothers ARE going to think she knows what she's talking about. Especially if they see another HV who says the same thing. Goodness, perhaps I'm doing my baby a disservice by not having him/her drink cow's milk yet, like all the other babies... I don't really understand what HVs are but I've read so many alleged incidents of questionable advice that they've given people on here that I really have to wonder about their training Are they trained nurses? Do they have any requirements to do professional development courses to keep them up to date...?

Oh, and of course I was bfing ENTIRELY for my own benefit when my 15 month old was cutting 3 molars at once and was having at least 2 NFs where she was not just sucking but chewing...

We've all seen how you write on here, I'm sure you can pen an eloquently worded letter to the appropriate people

[Erin M]

Oh how annoying Ali.  A little support would be nice, especially since you're actually FOLLOWING the recommendations.  Could you imagine if they approached the other recs with the same attitude? 

[*Ali*]

Yes, Nuala, HVs have to be a qualified midwife or nurse and then do a further 1year training course in specialist community public health nursing. I'm sure they would need to do Continued Professional Development as all other health workers in the NHS I know of do. I think sometimes they know the guidance but just think they know better from their years of experience at work and often as a mother too. 
I know what you mean Erin and I have often heard of them flouting other guidance too and recommending mothers who are struggling with their 4mo waking at night to just try a bit of rice cereal before bed to help them sttn. And then poor baby is laying in a bouncer because he can't sit yet and thrusting his tongue to push it all out. And mum is back a couple weeks later asking why he hasn't pooped in several days. Anyway rant over. I may try and get something down tonight.

On a slightly different topic, I am away for 48hrs from Friday afternoon to Sunday BT in a couple weeks and am wondering what others would do about missed feeds? Obviously I will need to pump while away but I will just dump it as I don't have storage or transport facilities to keep it fresh. I don't want the hassle of pumping a stock before I go but am not sure what to offer instead. I may tell DH to offer cows milk at WU and BT and just offer extra solids and water or diluted fruit juice for the middle feeds.  Don't think he needs 4 cups of cows milk. Is that what you guys would do or not?

[Fiver]

Yeah, I'd probably just offer water and maybe try a bit of cows' milk if he seemed up for it.

The BF training most HVs get is minimal.  I think they're only officially required to have sat on the UNICEF course, which, I think (might be wrong) is ONE DAY.

What they SHOULD be doing with BF issues is recognising they aren't expert in the area and referring on to BF counsellors/IBCLCs etc to give the proper support, but my feeling is that many of them have too much pride to be able to admit their weaknesses

[Khalam's Mama]

I was asked to fill a feedback form recently and wrote on it how the hv only give advice about weaning bf no matter what the problem, baby nw, mum returning to work, mum pg, baby not eating solids despite dropping bf etc etc. I could say nr baby was green with polka dots and they would say stop bf. I find being a health professional myself that it becomes cultural, if those you work with work in a certain way, one is more likely to adopt it esp if those in charge are not up to date and pushing for evidence based practice.
I have weaned all nf now for over a month but b is still ew. Frustrating. Guess the bf wasn't the problem. I darent ask my hv for any advice. I wonder what they would say now k is weaned if I asked for advice. Carry on as you are I guess.

[*Ali*]

I completely agree Amanda and I know there is so much to know about BFing but I feel like a day of training should be enough to know the basic guidance. It is more than I have had and while I'm not an expert I'm sure I would be better informed than any of the HVs I have met.

KM, they would probably still say he is clingy due to the BFing in the day and you should wean completely. That or CC anyway

[Fiver]

I wonder what they would say now k is weaned if I asked for advice

If my recent questions about D talking to herself for hours at night is anything to go by it would be to avoid eye contact, ignore her as much as possible, don't talk to her, don't go in unless completely necessary and keep the room dark, no cuddles, no physical contact etc

[Khalam's Mama]

Ugh!

[amayzie]

Good point amanda about the need for referral to a LC- that never happens! I would never dream of seeing an LC for issues.. even at 10 months when i was having problems that would never have happened! It should occur to me- but wouldn't!

KM- Great point about the weaning being a cure all! That is so true! I've actually had nothing to do with any form of health visitor.... just went through the dr, and the extended BFing doesnt come up!

I think too that the WHO guidelines also suggests something like 'frequent, on demand BFing' till 2- suggesting that actually 3, 4 or 5 (or more) BFs are what thy are talking about! ANd i like how people sort of dismiss the guides by saying 'oh- they mean in developing countries' Um, no- they don't, they would SAY that if they meant that!! It's clearly recommended for ALL babies!! And i'm not saying that people who struggled for 6 months before giving up should be continuing, no- everyone needs to do what works for them- but don't dis people that have a great BFing relationship and can continue on for as long as needed!  UGH! (It's 3am... i'm feeling a little ranty!)

[Fiver]

AMEN!