Here's the thing - HV who spout bollocks or judgmental shit are more likely to lead to a woman disengaging and then no longer attending a clinic. And at worse can do actual harm by giving poor advice. There are far too many examples of that on this thread.
I personally disengaged after they kept saying DS wasnt following his curve correctly but they couldn't give me an answer to how much expressed milk he should be drinking. They had assumed it was the same as formula, and didn't actually have figures for breast milk. I had found this out from a reputable website. They just kept telling me to top up with formula. On top of this he WAS following the curve for his centile for children in Norway (which has a taller population who aren't as overweight and much much higher breastfeeding rates)!
I felt like they just didn't know what they were talking about and the repeated scolding was harming my mental health by making me ridiculously stressed despite the information I had sourced.
So I disengaged and felt better for it.
If I had been underfeeding DS and done nothing they'd have been no follow up either though. If they thought I was getting it so wrong, why was there no follow up? Or was it just them being particularly over enthusiastic about formula milk?! (Which is completely the opposite to so many other women's experiences!)
It seems bonkers that given that they are supposed to be encouraging breastfeeding there was such a degree of lack of knowledge about it. I expressed instead of using formula because we had problems - in theory this should be the second option after breast feeding, but they didn't know anything at all about it.
It stuck me they had such a narrow view on breast feeding - scolding those who didn't get it right for going to formula, but also not having enough knowledge to encourage different ways to support breastfeeding either.
I totally do not blame women who don't - it felt like our entire system was geared up against supporting women with breastfeeding and instead had high moral opinions about it without anything actually bloody useful. Of course women are 'going to fail' , they've been set up to 'fail'. And it's not their fault. They've eventually realised that both their mental health and their child getting some food is better than torturing yourself trying to breastfeed without adequate support.
I was lucky and was able to continue. And I do consider myself lucky. I got support from a neighbour at just the right time otherwise I'd have given up. DH was amazing with finding information to reassure me I wasn't going mental and supported me with expressing when I felt like I was going mad. So many women just don't have the benefit of that and they do the right thing by switching to formula due to the circumstances.
I should add to this, I got pissed off at DSs 1 year check up when the midwife told me it was about time I started weaning him off breast milk even though that's not the recommendation! I was perfectly happy with it, and it wasn't a problem. Why on earth did she tell me this when we were happy continuing and WHO say until 2 years old if both mother and child are happy with this? If we were struggling, or there was a problem, fine but it was unsolicited, unwanted and poor advice.
This is what does my head in. The bad advice and the lack of support. And then scolding when you don't follow their shit advice or don't have access to the support you do need.
The amount women are infantilised and treated as if they are stupid throughout the system but then abandoned when they do ask for help IS one of the issues here. Women who are unable to decide what is good and what is poor advice are particularly vulnerable too because they end up getting treated like shit by a bad HCP on a power trip and who doesn't know what the fuck they are talking about themselves far too often.
I sometimes wonder for every woman they help, how many they end up being a problem. Which really does bring into question their effectiveness - even with safeguarding concerns.