HVs...What is the most effective, yet kindest way to complain about a HV's shocking BFing advice?

(70 Posts)

She told me my 7 month old should be on 3 breastfeeds a day after solids and at no other time. If he is hungry in between to offer him yoghurt or a snack.

I asked if she was sure of this as I had read widely and quite differently and she told me that this was fact. She offered me a sleep/feeding talk that would support this.

munchkinmaster Tue 22-Jan-13 05:36:41

I do think suggesting breakfast before milk is mad. I can imagine a hungry dds attitude to sitting in her high chair, ravenous as I make breakfast. But then if you offer milk in between meals who is to say if they are after breakfast or before lunch?

I can't find the thread I posted when the HV gave me similarly duff advice (in a similarly patronising way: 'it'll be mum nil, baby one if you give in and give him a BF') but someone kindly posted me a link to the UNICEF and WHO advice - which the NHS base their advice on - which clearly states breastfeeding ON DEMAND should continue after six months and that milk should remain the primary source of nutrition until 12 months. This advice was echoed by the Breastfeeding Network when I phoned them. Unlike yours, OP, mine's just not terribly interested in food, and 'weaning' (which infers to me a gradual process) would be turned into 'starved into accepting a less acceptable alternative' were I to follow the HV's advice.

Found it!

Cite pages 10 and 16 when lodging your complaint.

Maximilimum Tue 22-Jan-13 07:01:37

My HV told me at 6 months my DS should be on three meals a day, I said we had just started BLW, which she promoted but still insisted he should be on three meals already, not sure she understood the BLW concept!
Also said I should not be feeding at night, should do CC.
Until 6 months they tell you feed on demand and follow the baby's lead, then it's like a switch gets flicked at 6 months and you are supposed to stop feeding at night and stuff them with food!

I agree with a PP - they're supposed to toe the EBF until 6 months line, but see it so incredibly rarely in practice that they get thrown when actually faced with it and can only base their advice on the practical experience they have of FFers who wean early. I was told 'we've never had anyone BF as long as you'. For seven months? Extended BFer me. grin

Since DC1 didn't eat more than a gram of solids a day until 10m (he was totally uninterested) I am quite sure that a 7mo doesn't need to be reducing his feeds that steeply. HVs are not experts on bf, alas.

More generally, though, when I've needed to complain about a HV at clinic I have done so by first speaking informally to another HV on the team whom I trusted and who is the unofficial bf expert on the team. Her acknowledgement of my concerns helped me; and she was able to bring it up as a team concern rather than a directed complaint.

Bonsoir Tue 22-Jan-13 07:33:04

If I had my time again and was weaning another fully breastfed baby, I would try to adopt the French thing of four meals a day, at 8am, 12 noon, 4pm and 8pm. With lots of vegetables.

Thank you Elpha.

Munch Her advice was factually incorrect, but worse she was insisting it was fact rather than opinion. That's what I will complain about. She is also painting a picture of a scenario, totally out of the realms of possibility with an 'on demand' bf baby, that she is 'selling' as ideal, which undermines bfing as recommended by the WHO and the NHS.

Munch

'Between 7-9 months I think one should be aiming to get to three meals, 3 feeds, 2 snacks with all but morning feed being solids first?'

Why?

jaffacake2 Tue 22-Jan-13 08:06:38

As an Hv I think sometimes it is very difficult in clinics as mums have different agendas behind the questions. I am not saying this is the case with the op on here.
I have had mums crying saying that their 8mth old is breastfeeding 2hrly throughout the night and wont take solids through the day.The advise then is to see that the baby is on a 24hr clock and if they are taking lots of calories in the night then they will not be interested in food in the day.
Other mums are very happy to have 24hr demand feeding with minimum solids at 8 mths which is their choice and our input should be to recommend vit d drops as per govt guidelines.
Its hard to give advise out of context as there are so many different scenarios.As long as the advise is nutritionally safe then there are differing ideas.

Mosman Tue 22-Jan-13 08:09:20

Veggies given to a baby at 8pm would result in you changing a pooey nappy at some ungodly hour.

Thank you jaffa, but no matter what the woman's agenda or how many tears, a HV shouldn't be giving out poor advice.

I didn't (and never have in 3 children) been given any information on vit D. And 3 breastfeeds a day is VERY poor advice isn't it? And there is no research that shows that more veggies will make a baby sleep through the night.

BrainGoneAwol Tue 22-Jan-13 08:38:36

Highjack - it's not just HVs. My pharmacist suggested I put iodine on my episiotomy! shock
But then he also asked if it had a dressing on it... hmm

jaffacake2 Tue 22-Jan-13 08:39:52

Yes you are completely right, safe nutritional advise should always be given regardless of the agenda.
All Hvs go through breastfeeding training based on UNICEF guidelines so there is no excuse for bad advise.
Just wanted to point out that women often present a situation which is at odds with current advise,then you have to consider all aspects.
Last week I had a lady very upset that she wanted to breastfeed but couldnt. Finally it came out that her partner would not let her breastfeed as part of a whole DV situation. It would have been wrong to go down all the benefits of BF when she was not in a position to do so.And yes it did go to Childrens services,DV outreach and a safe refuge.
Just one example of how there are different scenarios HVs face in clinics.
But still no excuse for poor advise.

jaffacake Where/who informs you to give out that advice? Are you able to point us in the direction of the evidence that underpins that advice? I was one of those mothers crying about BFing every 2 hours throughout the night, with a baby not interested in solids during the day (but also BFing 1.5 to 2 hourly through the day as well to make sure he wasn't reverse cycling - he wasn't). I phoned the HV to find out if there was an NHS-run sleep clinic to help me devise a plan and that was the outrageous advice the HV gave me. A baby who BFs through the night is not a hungry baby who needs more solids during the day - it's a baby who hasn't yet learned to get themselves independently through sleep cycles and needs the sucking to do it. I'm not aware of any evidence to demonstrate that solids improves night time sleep. AFAIK it's folklore that HVs trot out as evidence-based advice. It treats BFing like its only function is nutrition when, particularly at developmentally-leaping and teething stages, it's soothing and pain relief as well.

PS DS is on three meals a day now, plus snacks as far as possible - still feeding 1.5 to 2 hourly throughout the night. IME linking food intake to sleeping is a complete non sequitur.

BrainGoneAwol Tue 22-Jan-13 08:45:15

Apologies - hijacking over.

jaffacake2 Tue 22-Jan-13 08:48:43

Elpha, yes there are situations where the baby is breastfeeding throughout the night due to a sleep association with suckling and I run a sleep clinic in our area if parents need help in that situation.
But I have also had babies who will not feed on solids in the day because they are breastfeeding throughout the night.The advise has also been supported by paediatrician and a paediatric dietician.HVs do liaise with the experts if there is a problem.

Mosman Tue 22-Jan-13 08:53:17

It's advice arghhhhhhh

munchkinmaster Tue 22-Jan-13 09:13:40

I thought that because that's what I'd read.

It was a genuine question as I'm wondering what everyone else is doing that is so different?

(My baby eats 3 meals a day, 4 feeds, one episode of food throwing that we politely refer to as ''snack time.". [don't see the 4th feed as an issue as I'd rather she took milk during the day than at night]). Just not sure why advice so wrong, rather than the way it was given?

CailinDana Tue 22-Jan-13 09:15:22

Glad I read this thread, I need to gear myself up for dealing with HVs when DC2 comes along. I avoided them for the most part with DS, but any time I engaged with them I was heaped with useless advice that I didn't ask for, with the implication being that whatever I was doing was completely wrong. I had to beg my friend to stop going to the clinic every month as the completely conflicting and sometimes frankly nasty "advice" she was getting from the various HVs was making her ill with worry.

I get what you're saying about adapting your advice to the situation the mother is in jaffa, but the main problem I encountered with HVs was that they didn't listen to a word I said, so far from adapting they were just spouting off their advice based on their own agenda and beliefs. For example I said DS was waking up at 5am which was tiring but we were managing, ie I didn't need advice on it. She then launched into a stream of shit about not bfing him. I said 5 or 6 times that I didn't bf him at that time, that he just woke up and wanted to play and IMO he would start sleeping later naturally as he got older but she still carried on banging on about how he was in a habit of waking up for breastmilk. IME that's a common theme among HVs - bfing leads to poor sleep - and I think it's awful, as it's bound to filter down to a lot of unsure mothers who are convinced to stop bfing in the belief that they'll get more sleep. In fact, any advice I've had has all centred around getting more sleep (as DS was always a fatty so we never had food issues) and the HVs never seemed to believe me when I said I wasn't bothered about his sleep. They also seemed shocked when I said DH shared nights - what a novel idea!! Their advice seemed to centre around getting the baby to "behave" so that the mother could sleep - it never seemed to occur to them that the adults might want to adapt to the baby until the baby was old enough to sleep through naturally (which DS did, entirely on his own, at 10 months).

Oh yes. I was also told to go to him and pat him and cuddle him when he woke but NOT feed him.

Obviously, I have done this aplenty as with 2 other small children feeding on demand often has at least some periods of waiting. I told the HV that the poor baby would scream in distress having milk so close, signing away and being refused it.

jaffacake2 Tue 22-Jan-13 09:30:26

Sorry spelling is crap advice,not advise,thank you !
I am better as an HV than a speller honestly ! smile

Gosh, she does sound useless set in her ways.

Again, I think mentioning it less formally through a better local HV or your GP, if they are good, would be less official if you don't want to make a massive fuss.

Llareggub Tue 22-Jan-13 09:44:14

My DS is 4 in April and still has more than 3 breastfeeds a day. It isn't just about nutrition, is it?

TheCountessOlenska Tue 22-Jan-13 09:48:13

HV's are obsessed with weaning onto 3 meals a day at 6 months - I don't get it, DD breastfed through the night and had minimal solids till she was about 18 months. It didn't bother me that much as we co-slept anyway - she never dropped below her 50th percentile line (or whatever it was).

She's 2 now - not breastfed and eats brilliantly. Was slower than others to get there but I can't see it's done her any harm. She wanted breastmilk not food and that's what i gave her.

Don't think I will bother with baby clinic with next baby.

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