advice wanted breastfeeding/health visitors

[willyk]

Hi all, we would really appreciate your help/advice/thoughts


We had our ds four weeks ago, we also have dd who is 2.3years old, when she was young she had problems with weight gain and we felt the health visitors undermined my wife breast feeding, in the end we dual fed, but both my wife and I felt that we didn?t get the support she needed for breastfeeding. She was encouraged to get dd weighed every week, and tbh that really stressed us out.

Now with ds I feel we are, yet again, being undermined? DW is really keen to ebf, and she has done a breast feeding peer supporter course, and has received help from the people who ran the course,

He was born at 8lb4oz,and by day 10 he was back up to his birth weight, and we were really happy (for dd it took three weeks). My wife took ds to be weighed yesterday, and saw one of the health visitors we had when we had dd, she weighed ds and he had gained 9oz in 16 days. She promptly said to my wife ?here we go again?- meaning ?this isn?t enough weight gain?. I saw dw at lunch time today and her confidence is shot, she?s worried she doesn?t know when he is hungry/windy/tired, which is crazy, she is a fantastic mum, and imho is going an amazing job.

Now ds has had a cold for five days, and although 9oz isn?t massive weight gain considering this cold , I think that this is well within the normal range.

To be fair, dw also saw the health visitor we would usually see, and she wasn?t concerned by this weight gain, but I feel like the damage is done.


Reading back I?m not really sure what advice I want/am hoping for, but really appreciate any thoughts??.

[SamSmalaidh]

I would only take him to be weighed once a month at most. So long as he is getting bigger and looks healthy and alert you don't need to see the HV.

[sarflondongal99]

Is there a particular reason you are seeing the health visitor? It's not mandatory, and if it's undermining confidence just don't go again.

[MrsCantSayAnything]

I don't know enough about bf to comment but I know about arsey HVs! I complained about mine....stupid woman she was...all thoughtless comments. You are happy with the one you see regularly which is good....when your wife goes to the clinic again, she does not have to see the arsey HV....she can ask for another.

[MrsCantSayAnything]

If the OPs wife is like me, then she might enjoy going to the clinic. Nothing wrong with going regularly if it helps you.

[Jenijena]

I'm not an expert, by any means, but it sounds like you're all doing a great job.

I've yet to meet a health visitor I haven't felt patronised by. Even the babies from my NCT group who gained weight above centile growth were clucked at with a "well, you're getting there" talk.

You don't have to have your baby weighed every week just so the health visitor can be rude and undermine you I know in a few places there are breastfeeding support groups with their own scales, and plot it on your own red book. Get the breastfeeding support you need from hospitals, breastfeeding drop in groups, NCT, LLL.

Give your wife a hug, tell her she's doing a fantastic job (I'm sure you're doing this already) and if you are able at all to go with her to the HV next time, then do so.

[EauRouge]

Congrats on your new DS :)

Your poor DW, no wonder her confidence is shot :( "here we go again" is not a very sensitive thing to say at all! Is there a breastfeeding group nearby that your DW can get to so that she can get some support? Can she have a chat with the people that ran the BF peer supporter course?

The right support is so important and it can be easy to undermine the confidence of a new mother. She's lucky to have a supportive DH in you :) and maybe some additional support from another source will help to rebuild her confidence.

Weighing a baby can be helpful but it's not compulsory to go if you're not finding them helpful. Could you or someone else go with her to the weighing sessions if she still wants to go? How about getting your DS weighed somewhere else- GP surgery perhaps?

[TheCountessOlenska]

I EBF'd very confidently and in retrospect I put that down to me being a lazy moo and never going to baby clinic! I found out that DD had regained her birthweight at my final HV home visit - then I never know what she weighed till her 1 year check.

I could see she was alert, growing and feeding - don't get the HV weight obsession

[TerrariaMum]

I can only go by my own experience. Is your son happy and healthy in himself apart from the cold? Is he wetting/soiling nappies? If the answers to those questions are yes, then I wouldn't worry. Also, it is normal ime for him to want to eat ALL THE TIME. Their stomachs are only the size of walnuts at that age.

Again, I can only go by my experience, but when DD was that age, if I was ever in doubt about what she needed, I offered her a feed. That was pretty much always what she wanted.

You sound like a very concerned and supportive husband so I will tell you something my own DH did that really helped: He did and still does all nappy changes when he is at home. This freed me to concentrate on bf and I really think this made a difference.

Feel free to PM if you want.

And congratulations on your DS.

[willyk]

Thanks all, I have suggested she speaks to her friends from the breastfeeding group, they have ben really helpful in the past. I'll also suggest she keeps the weighing down to once a month, but I know she wants to make sure he is gaining weight after our dd's problems

I think part of the problem is dw has put a lot of pressure on herself to ebf, especially having done a peer supporter course, and feels that she should be doing it with ease....

I'm not worried about him, he is alert, there's dirty & wet nappies, and he is growing length ways, I really just want my wife to feel confident in her ability to breast feed, and to get the right support to allow her to continue.

[mummysmellsofsick]

Once my DS was back up to his birthweight I never saw a HV or got him weighed again. I formally signed myself off the HV service when they started to write to me with reminders. I could see he was bright and alert and growing out of stuff regularly and I went to a local bf group for bf advice and support- have you got a local group? There are la leche league groups (look up their website) or many health services run groups led by HV with lactation qualifications. Normal HV are very variable in their feeding and weaning advice IME, you don't have to take everything they say as gospel.

[ElphabaTheGreen]

When you say your DD 'had trouble with weight gain', was that her only problem? i.e. was she completely healthy in all other respects? If the answer to that is yes, then I think that illustrates how much of a non-issue 'poor' weight gain alone is, and that DW really needn't worry since she's had a baby for whom slow weight gain meant nothing whatsoever in health terms. I think I've ended up with one of the only sensible HVs around - she never weighs unless there is a clinical indication that something is not right and I so wish that more would take that position. So many panicked mums with perfectly healthy babies end up on here in a tizz because some genius HV thinks the weight is a problem, despite the baby being completely healthy otherwise.

It sounds like your DS is like mine - long and skinny! Let me know if you ever source baby braces to keep their weeny trousers up. These are for being a caring dad and DH.

[ipswichwitch]

The thing with weight gain is that it doesn't follow those perfect lines on the chart. Some weeks they gain lots, other weeks not so much. My very sensible HV advised against getting DS weighed too often, even though we struggled with poor weight gain (due to underlying condition) for that very reason. When you plot the weight on a graph it often looks like steps going up rather than a nice smooth curve iyswim. She said that weighing too often would show that some weeks he hadn't put on much, which is demoralising and damaging to my bf efforts.

I would say (as others have) that as long as there are plenty wet/dirty nappies and they are bright and alert, then there's probably little to worry about. Well done you for being so supportive

[Loislane78]

Fair enough 9oz isn't a 'massive' gain but my LO doesn't gain much more than that every 14 days and no one seems remotely concerned - kinda arbitrary weighing over short time scales anyway as when you're dealing in oz, the timing of a poop or feed could impact.

Agree with what the other posters have said. GL :)

[Flatasawitchestit]

OP I wouldn't worry at all, and you sound like a supportive husband asking advice.

I would discourage the weekly weighs, unless he is showing signs of being unwell or no regular wet/dirty nappies etc.

I think 9oz gain is ok myself. I've got a 3 week old baby here, and she didnt gain weight until day 10 (7days in scbu) and I know if it weren't for me being a midwife and being assertive I'd probably been encouraged to top up [sceptical] my baby was peeing pooing a good colour and fed well, she was just a slow starter. She's steadily put on weight since (sometimes just 30g in 4 days ) and is now upto birth weight. I've declined weekly visits for weighing and will go when I feel like it as the anxiety surrounding weighing can be horrible.

I was encouraged bullied into switching to formula 6 years ago but wasn't as well informed back then but it's a decision I've regretted for a long time.

It's a shame the HV isn't more encouraging, it sounds like she's undermining and that's such a shame.

Good luck.

[SirBoobAlot]

at the rude staff at the weigh in, I'd be putting in a complaint about that. Your poor wife.

Weight gain sounds fine. Weighing regularly tends to cause more stress than good, because you end up freaking out about it. And most midwives and health visitors will tell you that babies don't put on weight when we want them to, it tends to happen in leaps.

Remind your wife that the other health visitor was happy. Do encourage her to speak to her peer supporter friends; I'm a PS too, and we have all helped each other out along the way.

You sound very supportive, which is fab.

[Loislane78]

Sorry for thread-jacking but I don't understand (genuinely) why formula is sometimes suggested in these situations - just for the record I'm not anti-FF.

If formula had more 'calories' then you surely you can't FF on demand? Plus given BM is digested more quickly then they can feed more frequently and get more calories that way? I could understand giving expressed milk to monitor volume and easy feeding but really don't get the formula top up thing - or all FF babies would be huge and obviously they're not.

Am I missing something?

[PoppyAmex]

DD is 7 months and I still find this incredibly hard to talk / think about.

DD was 10lbs 9oz and actually looked bloated when she was born.

I was very fortunate to get an abundant supply of milk from day 2 (after c-section) and she had a flawless latch from the beginning. Never had a twinge of pain and she was an efficient feeder, albeit very sleepy and hard to wake up for feeds.

Enter first HV 4 days later and DD had lost 13% of both weight - we were sent back to the hospital (fair enough) and they diligently conducted all types of tests which confirmed she was fine. I was still made to stay overnight, express constantly and force feed DD every 1h 1/2. Formula was suggested by paediatrician and we dismissed it.

Midwives were AMAZING and gave me a lot of support, DD put on a few ounces and we were discharged the next day.

2 days later HV came back and there was no increase in weight (was exactly the same) and we were sent to the hospital again. More tests, all brilliant with her and the Consultant Paediatrician told me I "could" continue breastfeeding but HAD to top up with formula.

By this point my hormones were all over the place, I didn't understand the UK system that well and thought they might take her away from me.

My confidence was totally shot and I mixed fed as per doctor's instructions, whilst trying to stop my breasts from leaking like mad.

It took me WEEKS to establish breastfeeding again and after a great birth and brilliant days at home with the baby, the whole experience was horrendous and destroyed my confidence completely. Fortunately I had a lot of support from family and a brilliant DH.

Turns out she was just levelling out and there was nothing wrong with her (still in the 91st percentile to this day)

I haven't discussed this with any HCP, have limited HVs contact to the absolute minimum and can honestly say if/when I have another baby I would lie through my teeth about any breastfeeding problems because I don't trust the system.

The protocols might be in place to protect children, but they certainly didn't do mine any favours.

I don't know why I felt the need to write this, but I'm still so bitter and emotional about the whole thing and I hope your DW manages to regain her confidence and continue to do a fantastic job. Best of luck.

[PoppyAmex]

Lois the explanation I got was that, unlike breastfeeding, when you FF you can see exactly how much the baby is ingesting.

[SirBoobAlot]

Babies also don't have to work to take milk out of a bottle, so they tend to take more than they actually need.

Breast milk is actually higher in (good) fat content and is more quickly absorbed, so is better for babies with weight gain concerns.

[tiktok]

Some disturbing tales here about what some HVs say to mothers, and how it reflects on knowledge and abilty to support bf :(

OP - see if your DW would call a bf helpline.

Once a baby is feeding well and up to birthweight, it's current UK guidance that weighing more often than once a month is misleading and unhelpful....should be something in your red book saying this. There is literally no benefit in weighing a baby who regained birthweight at 10 days for a whole further month - and in your baby's case, it has brought your DW into contact with a tactless and unhelpful HCP, who has said something extraordinarily hurtful given the history.

Lets say the weight is accurate - and it may not be, he could weigh less or more :) - it is not a concern....assuming your baby is healthy, happy, I cannot see why she should make such a strange remark. The weight gain cannot be judged on this one reading - and if the HV did not follow up the comment with questions and advice about addressing this 'problem' then she really is not doing her job properly.

If your DW is a peer supporter she is in a good position to feedback about this HV's comment.

I hope she regains her confidence soon .

[NotQuiteCockney]

I've heard that, as long as a baby regains birth weight by two weeks, you can just get them weighed when they come in for jabs, and that's fine. (So you can weigh much less often than once per month.)

[TheCountessOlenska]

Like I said up thread - I never got DD weighed from when she re-gained her birth weight till her 1 year check. The nurse didn't weigh her at her baby jabs either!

It's not the law that you have to weigh them is it?

[Chopsypie]

FF wont necessarily fix the problem. I had similar problems with my youngest, who was 5lb 10oz at birth (born at 39 +2, just small!) and is still only 17lb at 10 months. I think I've had her weighed 3 times, after being told when she was 8 weeks old that she wasn't gaining enough. I knew she was fine. She has been formula fed from 3 weeks.

I genuinely don't see why the weight is important. For me, my baby is happy, healthy and doing all of things she should be, so I have no need to take her to the the HV.

[tiktok]

You're right, NQC - for most babies that's absolutely fine. In fact guidance for weighing frequency is actually 'no more than once a month' after the baby reaches birthweight unless there are concerns (I have just checked - this should be in people's parent-held child health records) - and that 'most babies will not need to be weighed as often as this'.

wiilyk could ask the HVs why they are departing from guidance issued by the Dept of Health, the Royal College of Paediatrics and Child Health, the WHO, and which is printed in the book which all parents get and which the HVs should know.