HV said no vitamins in bm after 6 months

[Jezzabell]

Went for dd's one year health/development review the other day and told HV that I'm still bf morning and eve, although to be honest I don't know why I ever talk to hv's everyone I've seen has been useless and really non committal about answering any questions I have (NHS Gestapo as my DH calls them!) Anyway after I told her that, she specifically said that there were no vitamins in bm after 6 months. I'm relatively clued up about most things and thought at the time this was rubbish, but didn't want to challenge her at the time with no evidence to back me up. I've since done a little online research and Kellymom brought up this:
kellymom.com/ages/older-infant/ebf-benefits/

In particular-
In the second year (12-23 months), 448 mL of breastmilk provides:
29% of energy requirements
43% of protein requirements
36% of calcium requirements
75% of vitamin A requirements
76% of folate requirements
94% of vitamin B12 requirements
60% of vitamin C requirements
? Dewey 2001

So she is giving out wrong information, it seems specifically to try and discourage me from bf still??!!

I'm a bit annoyed about this as there may be other bf mums who take the HV's word as gospel and this could be discouraging them from continuing bf when the might be happy to.

I'm thinking about writing a letter of complaint, to a relatively high level as I think this is wrong. Not sure who it should be sent to. Any thoughts/suggestions?

[Greywacke]

What she is probably thinking of is the recommendation by the department of health that all children between 6 months and five, with the exception of those that are having more than 500ml of formula per day, should have vitamin drops. This is not because breast milk is lacking but because of a problem with lack of vitamin D.

The correct advice would be to give vitamins, not to stop breastfeeding. I would begin by sending it to the health visitors office.

Concerningly here they don't do the one year review but that is a whole other topic!

[Pizzaexpress2]

The current guidance is that vitamin supplements are recommended once a breastfed baby is 6 months old. Formula is adequately fortified so not recommended when formula is main feeding choice.
I am sorry that he HV has given you the impression that she is against breastfeeding. It is wrong to state that there is no vitamin content in breast milk after 6 months, that as we know is utter nonsense.
I would also try and look at credible research. Kellymom offers some great advice and is often invaluable but I would want to explore a subject a little more widely than a parenting website.

[munchkinmaster]

Isn't it also about the iron. Hasn't baby used up all the iron stores from womb by 6 months and you need to find in diet from then on? Think it's hard to get iron from diet or milk so I think alongside vit d, that's why they recommend the vits.

Interestingly my baby wasborn in London was told vits from birth (I think due to huge multicultural population - easier to say all should get vit d) and where we live now it's 6 months.

[munchkinmaster]

She could have explained herself - did she actually tell you to get the drops?

[Jezzabell]

Thanks. I intend to do a bit more research, but the Kellymom info was referenced from a report in a medical journal (Dewey, 2001). She did mention about vitamin d later in the conversation, but me and DH are very outdoorsy people and are out most weekends, plus dd gets taken out for walks at nursery and gets plenty of daylight on the walks to and from nursery each day(40 mins), plus we all have a pretty healthy diet. DD LOVES fruit and veg, that is mostly what she eats at home. So again, telling me she needs vitamin drops when they've not really checked our diet, or explained why she might need them is a bit 'same medicine for all'. I'm aware there are babies out there that do need extra vitamins, but it does somehow imply that formula is better than bm doesn't it? We all survived fine before HV's were recommending vitamin drops at 6 months, what about before 6 months? Surely bm composition does not change that drastically at 6m and most babies start getting solids at 6m, so if anything, shouldn't their recommendations be to I've vitamins before 6m?

[NotQuiteCockney]

People used to spend more time outdoors than they do now. (Also, the vitamin D risk is higher if your skin is darker.) People also used to take cod liver oil, which is full of vitamin D.

Life has changed, a bit.

[jaffacake2]

HVs are told to give the recommendations from DOH which is that all children from 6mths to 5yrs should be advised to have vit D supplements due to the rise in cases of rickets in the UK.If a baby is formula fed then there are the supplements in the milk.
Thats what they are told to advise parents. If you dont want to do it then dont.

[Pizzaexpress2]

It does sound as if you have a great healthy lifestyle. Of course only you can balance up th pros and cons.
There is a huge amount of more recent research. Th d oh h website can point you to it.
Up to 6 months the baby has adequate stores of vitamins, iron etc so not necessary to supplement.
The recommended guidance is just that, guidance. Vitamin d is a big topic at present due to the rise in rickets an generally poor nutritional intake of so many children. That is where the recent recommendations come from. Some families really do consider cheese straws and quavers as adequate snack choices.

Well done on breastfeeding successfully for so long, it is great to hear. I am sure you won't feel pressured into stopping until you are both ready.

[FrantasticO]

Agree with jaffa

Did she tell you to stop bf which would seem unlikely or advise you to use vits?

Hvs give advice which as parents we can choose to implement.

Advising vit supps would be appropriate.

Well done in bf this long you have done a great job.

Hvs have a huge job remit wise and if we continue to bash them they might not exist. Not a good thing.

[Booboostoo]

The vit D recommendation seems to be given quite widely, e.g. I was told to give vit D until 5 years old both in France and Greece (countries with much greater sun exposure than the UK). Vitamin D deficiency can cause quite a few problems and I don't think there are any risks associated with its supplementation at the recommended levels.

Another issue with toddlers is iron deficiencies which can be quite common. DD (now 21mo) had to take iron supplements for 3 months because she was quite a boob monster and was eating loads of fruit and vegetables (all good stuff in themselves but she was not getting enough red meat). There are some calls for iron checks to be made standard for all toddlers (some point between a year and two years) but they do involve blood testing which is a bugger to do with such small children.

Your HV sounds ignorant and unhelpful though! I have been told that my milk is apparently water now and useless!

[Isandri]

New research just published says breastfed baby's are prone to vitamins b12 deficiencies. It's all over the news in Denmark. They think it's natures way of making them start solids. They've found a link with low vitamin b12 and poor brain development.

[munchkinmaster]

My baby hated the drops when she was tiny so I stopped until 8 months. . At 9 months she opens her mouth and patiently takes them. She eats a healthy diet and is out lots but it's reassuring especially as she is not big on red meat.

I think your health visitor explained poorly and I think it's symptomatic of haveing a tick box approach rather than a full understanding of why you are recommending things.

[Booboostoo]

munchkinmaster are your baby's drops iron supplements? It's not standard to give out iron, only Vit D. If she's not on iron supplements, red meat is one of the main sources of iron along with lentils and difficult to make up through other foods.

[munchkinmaster]

You're right there is no iron in the multi vit. Smells so irony though. Baby is a secret veggie and hates lentils so she will just need to be deficient

[SamSmalaidh]

Bless her, sounds like the HV is a bit confused and could use some training! I would definitely contact her manager and let her know.

[mercibucket]

It's worth supplementing the vit d. It has been recommended in france for at least the last 10 years, we're just quite behind the curve in the uk. Doesn't matter about outdoors exposure as we can't make vit d at all in the uk from around sept to april, regardless of how long we're outside. Wish I'd known more about it at the time and actually listened when I was told about it
Iron also worth keeping an eye on, hard to get from zero food to enough iron rich food in a matter of weeks when weaning

[Bakingtins]

You don't need to get "from zero food to iron rich food in a matter of weeks" because nothing magic happens at 6 months. Babies need to move gradually from having all their needs met by breastmilk to getting the majority of their nutrition from solids, but breastfeeding continues to make a valuable contribution to their requirements for as long as you choose to continue. They are not fine being exBF at 25 weeks and suddenly iron deficient at 26 weeks.lf the HV believes there are no vitamins in BM after 6m then she is overdue for some retraining and this should be pointed out. Whether BF babies on solids need to be supplemented is a related but different issue.

[mercibucket]

Iron stores last up to 6 months after birth. That depends on the type of birth as well last I read, so if like most of us, you didn't wait for the cord to stop pulsating before cutting it, then the baby's iron stores are lower. Current advice is not to wean until 6 months. So after 6 months, yes, iron stores are low. There are a lot of articles out there about iron deficiency in babies, it's v common.
And yes, imo it is hard to go from zero food to iron rich food in a matter of weeks. We were brought up on carrot purees from aged 12 weeks or similar, with plenty of time to get through the puree stages up to the meat. A lot of people still start the weaning process in stages, and tend not to start with steak and eggs.

[mercibucket]

Iron stores last up to 6 months after birth. That depends on the type of birth as well last I read, so if like most of us, you didn't wait for the cord to stop pulsating before cutting it, then the baby's iron stores are lower. Current advice is not to wean until 6 months. So after 6 months, yes, iron stores are low. There are a lot of articles out there about iron deficiency in babies, it's v common.
And yes, imo it is hard to go from zero food to iron rich food in a matter of weeks. We were brought up on carrot purees from aged 12 weeks or similar, with plenty of time to get through the puree stages up to the meat. A lot of people still start the weaning process in stages, and tend not to start with steak and eggs.

[leedy]

Actually one of the first things my 6 month old DS1 ate was a lamb chop... (I am not joking, the photo is hilarious)

[mercibucket]

Anyway, wrt the weaning, that was my experience. Maybe people are better at it these days. Dd was iron deficient at 9 months despite a varied diet but she was ebf til 6 months and still bf a lot at 9 months. I wish in retrospect I'd focussed a bit more on the iron side of her diet rather than believing that bm was the main source of nutrition at that age. Maybe guidelines are different now?

Wrt the vit d, I really really regret thinking I knew best on this. It's so easy to supplement

[mercibucket]

:) leedy, sounds funny

[mercibucket]

:) leedy, sounds funny

[stargirl1701]

Just lacking Vit D I think.