Aibu to be so angry with hv?

(42 Posts)
Fairy130389 Thu 25-Jul-13 15:17:55

My babyis 4 weeks. He was mixed fed but now is mostly ff. so far this week, when taking him to gp I have been advised to 'water down him formula'... When I looked this up online it screamed alarm bells, so ran it passed my hv who agreed that it was not advisable. I asked if she felt it was serious enough to report to practice manager as gp's advise was poor.

I then phoned our local midwife service who offer 24 hr feeding support etc last nit to ask about how to prepare feeds in advance. I was told to boil the water, cool it, leave it on side and add powder as necessary. Posted here and was told by everyone that powder is the dangerous bit and needs the water to be hot t sterilise it. So, again it seems like bad advice from midwife.

Phoned hv today just for clarity really. Understand that advice is make up as you go but as this wont a,ways be possible, would like to be able to make informed decision as to how I do it based on risks. Hv absolutely refused to discuss it. Just said 'I think in your case fairy, as you like to look everything p online, I will just give you the standard gov advice which is to make up feeds as you need them.' When I asked her to tell me at least the safest way so I would not do something stupid due to ignorance she just reiterated that feeds need to be made then and there and she couldn't advise any differently.

I am sooooooo angry. How can I make an informed choice??

www.nhs.uk/Conditions/pregnancy-and-baby/Documents/Guide%20to%20bottle_feeding.pdf - formula feeding leaflet.

The safest way to make up feeds is to make them up as required. If you want to make up in advance then it is best to make the feed up with water over 70°C, cool quickly and store in the fridge for a maximum of 24 hours. You could also use cartons if out and about or for night-time feeds.

If you dont want made up formula hanging about for hours on end then you could make up a couple of bottles, put them in the fridge and then once they have been used make up another couple to replace them.

Shamoy Thu 25-Jul-13 15:32:04

Not sure why you are so angry with Hv? You have told Hv you are reporting the gp and the midwife for giving you info that is not right so she is sticking to the recommended correct way to do it as her advice so you have the absolute correct info from her? That's how I read it!
If you want a way of using formula without making up each time that is totally safe then you need to buy pre made up cartons and pour it into a sterilised bottle when you are out and about. Hth

the leaflet above gives information in what to do if you cant follow the guidelines strictly - maybe you should show it to the hv!! There are going to be occasions when you cant make the bottles up as you need it so there has to be a workaround solution for those occasions e.g. pre-made cooled formula or ready made cartons, etc

juule Thu 25-Jul-13 15:45:00

I agree with Shamoy.

Nightfall1983 Thu 25-Jul-13 15:46:35

But your HV is 100% right, formula should be made up only when needed - not in advance. Do you know the quick method for making up a bottle of formula safely? This method means it takes only a couple of mins from starting to make a bottle to it being ready to feed:

In advance:
Measure out the appropriate number of scoops of powder into a clean pot.
Measure out 2/3 of the required boiled water into a sterile container - bottle or similar. So for 6 scoops this would be 120ml.
Fill a (good) Thermos with (boiled) water at around 80 degrees. Either use a thermometer or boil a litre of water in a kettle and wait 20mins.

When needed:
Put 1/3 of water at 80 degrees into a bottle (for 6 scoops this would be 60ml). Add the formula, replace the lid and shake for 10 secs.
Now add the 120ml (or whatever it is) of cool water into the hot formula, shake briefly and it's ready.
TaDa.

thats what she was looking for from her hv though Nightfall1983, a safe way that is faster for making up formula. It can be safely made in advance too, as stated in the leaflet above.

Nightfall1983 Thu 25-Jul-13 15:57:39

Actually the leaflet says that the ONLY safe way to make up formula is to make it up when needed. It then goes on to give the safest method for making it up in advance if you are going to do it otherwise but does specify that it is not as safe.

Agree that it would have been nice if the HV had some ideas for making up the formula faster but maybe she didn't know? I had to "invent" this method for myself (I have seen others posting it as well so I do realise I'm not unique for "inventing" it).

purrpurr Thu 25-Jul-13 16:01:41

Crazy, just report everybody, can't go wrong then can you?

heidihole Thu 25-Jul-13 16:04:06

I agree with Shamoy.

You told her that you'd reported another HCP for giving advice that went against gov't guidelines.

How can you not understand that your HV is now not going to tell you ANYTHING other that the gov't guidelines which is to make up as you go along.

FWIW I made them in bulk and stored a days worth in the fridge. Baby still alive.

Fairy130389 Thu 25-Jul-13 16:30:29

I did not tell her I was going to report the gp. I did not report the gp. I had a conversation with hv that went like thi 'gp has suggested watering down formula, I'm a bit worried about this, is this ok?' Hv ' we would not suggest doing that, it can make baby ill'. Me ' oh, do you think it is worth me mentioning that then S I wouldn't want him giving out the wrong advice?' Hv 'yes, if you wanted you could report him to practice manager' me' well ill have a think, not sure of it is worth the hassle'.

I did not even tell her that I had spoken to another midwife. I asked her to tell me an alternative to making them up as needed, that would pose the least risks. I wanted her t give me some options so I could make an informed choice.

I am capable of making my own decision but I don't want to do it wrong because I don't have the information to weigh up the risks appropriately.

Fairy130389 Thu 25-Jul-13 18:03:32

But thank you nightfall for the info, that's the sort of thing I was after.

AidanTheRevengeNinja Thu 25-Jul-13 21:17:59

It sounds like her attitude was the problem - "as you like to look up everything online" sounds a bit defensive and snarky.

My HV is perfectly nice but I don't really see the point of her, if I'm honest. I just look up the NHS guidelines myself and then come on Mumsnet to find out what real people do

Fairy130389 Thu 25-Jul-13 22:16:11

yes aida, thats exactly it. The way she spoke to be implied that she had my card marked as a difficult moany complainer and she therefore wouldnt offer me any info incase i found something to report her about. She had started to tell me about what to but then thought better of it, paused, and launched into her sticking ridgidly to guidelines speech. I am not a complainer at all, i'm not a difficult person, i'm just a new mother baffled by ff and not wanting to do it wrong! now i feel like shit.

itchyandscratchy26 Thu 25-Jul-13 22:25:36

How CAN the HV advise anything other than the latest guidelines? Were you expecting her to endorse some other 'easier' method..
DOI- FF my own twins. I use 70 degree water to make up the feeds, add the powder and then make them in batches to store in fridge for up-to 6 hours. I have to do this to survive managing twins. BUT it is not best practice and I wouldn't expect any healthcare professional to err from giving correct info.
If I had the slightest inkling someone was trying to 'second guess' me at work, or may report me in some way, then I would give rigid and up-to date guidance that is based on evidence, not personal opinion. i.e... do as I say, not as I do.

Fairy130389 Thu 25-Jul-13 22:31:44

the nhs website says if you have make up in advance, you should store in the fridge for 24 hours. those are still official guidelines. all she had to was point me in that direction or give me that advice herself, or, heaven forbid, a leaflet telling me what to do. it was my first day moving away from pre made as she suggested trying on comfort milk which doesn't come pre-made.

instead she made me feel like a trouble maker and someone that had to be managed.

LaChaiseVerte Thu 25-Jul-13 22:37:43

It seems a bit unfair that your ire is directed solely at the HV. Why not write a thread about a GP giving poor advice, or a MW giving downright dangerous advice? People love to bash HV (many may have good reason but it's practically a sport).

Your HV gave you the advice re: the safest way to make up formula. You pushed her for further methods which she didn't feel comfortable to advise on and she said so. For her to state that you look everything up on line, you must have said something surely? Otherwise, why would she make a wild statement like that? If her tone was off, it maybe because you wouldn't take the advice she was giving?

There are a couple of links on line to the "second best" method to make up in advance, but they are more risky than the current advised method.

LaChaiseVerte Thu 25-Jul-13 22:40:52

Here is is very clear that not making up feeds fresh is a more risky practice.

Viviennemary Thu 25-Jul-13 22:41:33

I'm not surprised the HV doesn't want to give you advice. You've already complained about the advice given to you by the Midwife and the GP. I think she did the absolute right thing in advising you of the best way and sticking to it.

TheSecondComing Thu 25-Jul-13 22:42:02

Message withdrawn at poster's request.

Fairy130389 Thu 25-Jul-13 22:44:46

because i was frustrated by the poor advice from the gp and mw which was exactly why i went to hv for clarity. her comment about me looking everything up online was because i once joked that mn was my bible, and because when i talked to her about whether to follow gps advice i mentioned that i had read online not to mess with formula.

to be honest i am sick of the conflicting advice, being told one thing only to be told after that the advice given was dangerous etc. i just wanted somebody to tell me what the actual guidelines were: i.e - make it up and put it in fridge. iwas initially going to make the thread more along those lines, but as i was in tears by hvs comments i thought i would seek support in that vain. more fool me.

Fairy130389 Thu 25-Jul-13 22:49:17

Just to clarify I HAVE NOT COMPLAINED ABOUT A SINGLE HCP and have noot told hv that i had or would either. all i wanted to know was if there was another way to do feeds, overnight, so ds doesnt have to scream for 30 mins whilst his milk cools down.

Fairy130389 Thu 25-Jul-13 22:53:31

clearly the answer to the title is that IABU then. maybe i am just over sensitive.

LaChaiseVerte Thu 25-Jul-13 22:54:07

I'm sorry that you're upset. Are you finding things tough in other ways? Is the comfort milk for a reason?

Your baby is only 4 weeks old and this is all new and difficult, but I think this is something that really doesn't need all this aggro.

The guidelines are not to premake and store in fridge. They are to make each feed as it is needed with nearly boiling water and discard after an hour. IF and only IF you HAVE to premake your formula than you can mitigate the increased risk by making up, flash cooling and storing in the back of the fridge at less than 5 deg for no more than 24 hours and a lot less if poss, or use premade stuff.

You now have several sources of written information to help guide you, and a lot of peer advice from MN.

You could perhaps make an appointment with hv to discuss all the issues and explain your need for further support, and maybe follow through on a calm, written complaint re the mw or gp if you feel their practice is dangerous.

purrpurr Thu 25-Jul-13 22:54:19

Fairy in fairness I can see where you're coming from completely, I find FF baffling. I'm uncomfortably aware I'm not doing it the recommended way. We boil and cool water, refrigerate, then when it's feeding time, add the powder then. Any unused feed is disposed of. Our understanding is that whilst the powder is not sterile it is not a seething melting pot of bacteria and maggots. So in the time It takes for the water to be added and the milk to be eaten, it can't turn into inside-melting poison.

DD is 9 weeks and alive. And making an ahhh face at me so I better go add some powder to some pre boiled cooled water...

LaChaiseVerte Thu 25-Jul-13 22:56:49

all i wanted to know was if there was another way to do feeds, overnight, so ds doesnt have to scream for 30 mins whilst his milk cools down.

Flash cool it to feeding temp, that is the optimum method as per the NHS guidelines. What matters is the powder hitting the water at 70, once it's done that you can rapidly cool it to feeding temp and feed.

maybe i am just over sensitive.

You're 4 weeks post birth - it goes with the territory.

Fairy130389 Thu 25-Jul-13 23:07:26

Sorry to be thick but what is flash cooling? running under cold tap?

I guess I am finding things tough, generally, yes. I am v emotional and a bit isolated, I dont have mum friends who I can ask these questions. In fairness to HV I had had enormous row with DH this morning so have felt like shit anyway and she probably tipped me over the edge...

he is on comfort milk since HV told me I was over feeding him as he was taking 4oz and then still rooting looking for more 2 hours later. She has suggested comfort milk so he will go longer between feeds.

feeding every two hrs or so is totally normal for four week old babyhmm
pita yes but totally normal and not a reason to use a different milk

Fairy130389 Fri 26-Jul-13 00:38:08

That's what I thought but she told me I was over feeding him and would make him ill!

Fairy130389 Fri 26-Jul-13 00:39:32

I think it was the quantities to be fair - her argument was every 2 hrs is fine, ifit is say 2oz, but he was having 3 or 4 oz at a time

purrpurr Fri 26-Jul-13 02:09:58

I find it odd that your HV would make this an issue. I'm sure it's possible to overfeed a baby but I have one and I struggle to encourage her to have the right amount of formula, I certainly couldn't feed her more than she needed. So in that sense your HV is saying your baby is too hungry? At 4 weeks? I just don't get it. What are your instincts saying Op?

Twinklestarstwinklestars Fri 26-Jul-13 02:31:36

My 4 week old has 5oz sometimes every 2.5-3 hours, he's on comfort milk but because he had tummy ache on sma so my hv told me to use it. I wouldn't say you were over feeding and not sure how comfort milk would make him go longer between feeds?

I have one of the tommee tippee perfect prep machines and find it handy as only takes about a minute to make a feed. I know there are cheaper ways of doing it but this is great for me.

ab00 Fri 26-Jul-13 03:04:15

Fairy sorry you're upset, the early days of parenthood are tough! We combined fed ds1 as he needed top ups in the early days & we were never able to get him off them. We'd not planned to ff so knew bugger all about it & then got ourselves in a bit of a tizz with what to do & how.
Our hv explained to us BEST practice as per Nhs & Who guidelines is to make each feed as you go as although the formula powder is made somewhere clean it is impossible for them to sterilise so there could be bacteria that is harmful to your baby in it (if may not make you or I poorly but a baby is a whole different ball game). The powder needs to be added to water that is at least 70 degrees to ensure this is killed. It then needs to be used within 2hrs to make sure it's at it's best & no nasties have time to appear & multiply in what is now essentially milk. All guidelines say that formula CAN be made in advance & stored in the fridge for no longer than 24hrs if you have no other choice not that it SHOULD. Again the reason for this is because even in the fridge the feed to does not stay at its premium condition for a baby (your own milk can go off in the fridge if you follow my drift). My hv explained people used to make up ff in advance but as people didn't rotate the feeds correctly or store them properly babies are getting poorly, in some cases very poorly, & this was an avoidable risk if feeds were made fresh hence the guidelines.
Personally we made all feeds fresh or used a carton for night feeds. To flash cool we held under a cold running tap of filled a jug with cold water & ice cubes - worked a treat to cool it quickly!
Imho it does sound like you have had some really poor advice from all corners, hv included re comfort milk & overfeeding. Babies are very good at self regulating & the amounts on the tin really are just guidelines, some babies will want more, some less. Sometimes they will want more 1 feed & less the next. With ds we found it always averaged out over a day. At 4 weeks your lo is still tiny with an even smaller tummy so will need feeding regularly, if he wants more give him more, you may find he wants less next time. So long as you don't force him to finish a feed when he's had enough or add extra powder you can't overfeed. I wouldn't have thought comfort
milk would make a difference to how much or how often he needs to feed as this is to help with colic? Sorry don't know too much about comfort milk but that was my understanding.
Re the advice you've been given you need to raise both the midwife & gp's advice with someone in a higher position to them as both is down right dangerous & had you have not checked (like someone else might not) you could have ended up with a poorly baby who is not gaining weight. That really does need addressing.
With your hv her tone was really off & I'd be pissed off too
. Her role is to advise, guide & support you & to ensure your babies well being. How's she going to do that if you don't feel comfortable with her because of her comments? In her role she should be used to mums with new babies ringing up to ask if it's ok that lo had just farted 3 times or had a nappy explode up to their arm pits or ask questions about the safest method of feeding & realise that mums are sensitive post natally.Maybe she meant it as a (very poorly timed) joke or it didn't quite come out how she intended? Maybe try & speak to her again, explain you're finding ff confusing & just want to do what's best for your baby to try to clear the air? Tell her your conversation upset you. If you still get attitude or don't feel comfortable with this or her then complain. You don't need that on top of becoming a new mum.
It may not feel like it now Fairy but it does get easier, surprisingly quickly & you sound like you're doing a fantastic job! Your ds is lucky to have a Mummy like you who is double checking she's doing her best for him!

Fairy130389 Fri 26-Jul-13 08:59:10

Purrpurr - my instincts are to fuck all the professionals and just stick to MN!

purrpurr Fri 26-Jul-13 09:30:51

Amen to that smile

itchyandscratchy26 Fri 26-Jul-13 10:29:32

Fairy, that came across loud and clear in the tone of your initial posting and I suspect that attitude will do you no favours in the future if you DO need medical advice that can't be accessed on mumsnet.

purrpurr Fri 26-Jul-13 12:37:39

Oh howay now, that's rot. You can be mistrustful of the medical profession but also be sensible enough to still take on board their help and advice. In this case, the Op has been given a variety of potentially dangerous pieces of advice from each corner of the medical profession in the UK and has been left a little peeved, not to mention a tad bewildered, as a result, which sounds like a common end result of being on the receiving end of the NHS to me.

It's not that she would deny herself or her child care, on the contrary, she is trying to make absolutely sure the advice she follows is right - and that is because each professional has followed a different hymn sheet to the last.

MortifiedAdams Fri 26-Jul-13 12:42:06

The GP.was wrong to advise what he did - you checked it online and realised. Some other patients might not and might blindly follow the instructions. Therefore it is worth speaking to the PM about it.

However re- the formula, the instructions are on the tin. That is that. Best practice, safest way etc. Why you felt the need to ask your HV about it at all I.dont know.

Likesshinythings Fri 26-Jul-13 12:54:19

The link from earlier is to an old version of the bottle feeding leaflet. Up to date one is here www.nhs.uk/start4life/Documents/PDFs/Start4Life_Guide_to_bottle_feeding.pdf
It hasn't been changed much and, importantly, the guidance is the same but thought I would link anyway

Fairy130389 Fri 26-Jul-13 13:01:37

Clearly I was being tongue in cheek, itchy. I was not asking how to prepare formula, I was asking whether, for night feeds to speed things up, there was a quicker way. I hadn't seen the nhs guidance.

I really think you are being unfair. I haven't complained about anyone, although probably I should have (gp), I just wanted to be sure I was doing the right thing.

Blobby11 Sun 28-Jul-13 11:45:30

For quick cooling of milk I put the bottle in a jug of cold water then stick one of those blue frozen blocks that are used in cool bags into the water. Nice and speedy!

MoominsYonisAreScary Sun 28-Jul-13 11:57:35

We used a flask so you don't have to wait for kettle to boil, then stick bottle in sink and run the cold tap. It cuts the waiting time down quite a bit, Tommee tippee do a flask.

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