To think that the Health Visitor should have had a little clue about this...

[backintraining]

I have previously posted on another thread about my DDs feeding concerns and just as I had reached the end of my tether, began questioning my ability as a mum and had flooded the kitchen with tears, a massive weight has been lifted.

DD is just coming up to 7wks, she was born at 7lb 15oz, I tried to BF initally for a few days, long story short I didn't have the milk due to previous operation, she lost loads of weight, became lethargic and I (heartwrenchingly) switched to formula. Anyway, she was incredibly slow to regain her birth weight, has limped her way to gaining weight over the past few weeks and in the last 2 weeks only put on 8oz, she is now 9lb 4oz. She has fallen from 75th centile to under the 25th. Basically she does not feed well, she'll take 2-3ozs MAXIMUM every 3 or 4 hours and has been this way pretty much since we switched. The most I get into her in 24 hours is about 17oz and that has not increased at all even though her weight has slightly. I have tried everything, including waking for more frequent feeds, dreamfeeding, changing positions... always the same result. She has 2oz, burps (or doesn't burp!) then maybe has a bit more then she's done, generally if I have tried to wake her or dreamfeed she refuses. She is otherwise relatively content, alert when awake, peaceful when asleep, regular wet/dirty nappies etc.

Anyway, the HVs have been repeating that she "really isn't having enough in 24 hours", "really isn't gaining the weight she should be", "really should be taking more than that amount at her feeds"....... the final straw was today when I took her to be weighed and HV said: "You need to see the GP for an urgent hospital referral. It may be that you need to see a dietician, this is failure to thrive." Cue me making GPs appointment for this evening in floods of tears thinking the worst.

The GP was absolutely lovely. He explained it as this - the weight a baby is born at is all to do with how the placenta functioned throughout the pregnancy and then how the baby grows is all to do with genetics. He said that in DDs case she was born on 75th centile but is not destined to "grow" along that or be that big. He said that she is feeding and gaining weight in a manner that is allowing her to find her own lower centile. He was furious that the HV had made the comments that she had and said he would be speaking to her.

AIBU to think that the HV should have at least had an idea about this kind of stuff. The basis of their work is monitoring how a baby is growing, are they gaining weight, are they following a particular centile etc?? If someone had told me this weeks ago it could have saved a lot of stress and tears.

I am sure that is true that most people are too busy to complain.
What is the most effective way of complaining? What aspects would be taken seriously and what evidence would be most useful?

Particuarly interested in HV and ex HV views. I understand complaints should be in writing to the PCT. When I tried to inquire by phone to the PCT as to whom my HV reported to as I wanted to speak to them no one would clarify the structure and said it was all changing hence I was unable to report her verbally to her manager.

Some of the "advice" people have been given here by their so called HVs makes me want to scream with frustration.

I only had the confidence to take it as far as I did (and I ended up as a non-exec on the health trust) because I am articulate, ballsy, well connected and rich enough to launch an offensive if they had turned nasty. What they get away with as far as the less able to defend themselves is concerned was a national disgrace and continues to be one.

latesummer - if you look on your PCT website you should be able to find something like this telling you how to complain. If you can't find anything you could contact your MP, easy to do by e mail. I know someone who did this when she was being bullied by her HV and fobbed off by the manager and the MP was fantastic, contacted the chairman of the PCT and there was a big investigation resulting in a letter of apology and the HV given a formal warning.

Just out of interest what about people who dont go to get their babies weighed ? I have to say i did the bare minimum i could get away with and none of my baies was big or gained huge amounts of weight , but they were well .

well with no 1 i got him weighed fairly regularly, then with no2, 3, and 4 i didnt bother after the 6wks check they were obviously growing, and were healthy boys and happy and content etc so i saw no need.

dd no 5 has gone through phases of not feeding well, so i took her to get her weighed more regularly, there was never an issue with her weight gain so it was primarily for my own reassurance. baibes generally tho grow, you can see and feel that they are getting heavier and growing out of clothes etc and if you want you can always weigh them on a wii fit or something?

The HV service isn't compulsory but it is supposed to be offered to all parents.

Complaints in writing will get to the correct individual if it is addressed to the clinical director and the headquarters address (which should be available on the internet.) If you bring up the PCT website the complaints procedure is usually on it.

A significant issue when considering the opting out option is that generally it will be families where there are problems such as drug/ alcohol misuse, domestic violence etc who disengage, not the average doing fine mothers on the whole. With the blame for many child deaths being squarely laid at the door of health and social care professionals when things go wrong, it is unsurprising that HV's will try to engage all families. There are many serious problems that put babies at risk and without support it is likely that children will suffer injury or death. As accountable practitioners, who are hauled in to serious case reviews on such occasions I would prefer to see as many mums/ dads as possible to prevent this if possible.

Anxious - if HVs hadn't hounded a woman like me they would have had more time to spend on the needy. Also, you still haven't explained why you thought an HV looking dirty was funny even less why you would think I would allow a baby less than a month old to be picked up by someone sporting dried bodily fluids which were likely to be bacterial in nature. Actually I think it was food but that is besides the point. I appreciate you are being loyal to your profession and are keen.

The other issue is postnatal depression. This can be mild or severe to the extent of purpeural psychosis. If a new mother is suffering from it she is highly likely to deny anything is wrong while exhibiting bizarre behaviour that is out of character, they can have delusions almost akin to schizophrenia which can make them hear voices telling them to harm the baby or themselves. Should health professionals respect her wishes not to intervene? Perhaps at the expense of her life or the childs?
My DF was drawing blood from her own arms with it, had lost 5 stone in weight and was seriously ill. Had it not been for the HV realising this and referring her to a specialist unit for treatment.

Married at what point was I laughing? I merely pointed out that most HVs generally start the day clean and get dirty at work and food stains on clothes are generally not bacterial! Human blood also doesn't routinely contain bacteria or we would all be quite unwell, there is the possiblity of virus's. However, babies are generally tested if mothers have hep B/ HIV, the HV would use a pinny and definately change clothes to do another visit or reschedule it.

Funnily enough I have always thought that maternal food intake and plasenta function directly effect the birth weight and often have little relation to the percentile the child ends up on. My three and lots of my friends babies have started out much heavier but then dropped to a much lower percentile. My eldest two dropped from the 9th to the bottom line while my last baby dropped from the 50th to the 9th. They are all very healthy and very bright and very coordinated. They don't look skinny, they just look healthy.

I think your HV could have handled things with more sensitivity. Yes baby has to be checked to be thriving but why cause such an emotional storm when mother is at her most vulnerable.

It's clear things have needed to change for a long time. Married you are far from unreasonable in asking the things you do. HVs should give accurate advice, should understand centile charts, should record information accurately and be clean - I take a change of top to work with me. Occasionally I need it too - especially after weighing a baby boy

Part of the reason we NEED changes though is because this has been an underfunded and demoralised work force for the last decade or so. When your active caseload consists only of child protection and you have nobody else to share the responsibility with then it's not a stretch to understand why you might lose all enthusiasm.

In the past 10 years very few HVs have been trained (the current Govt is tackling this).
I have been fortunate enough to work with some fantastic HVs in high need areas or not.
On the other hand I have met truly appalling HVs working in very nice middle class areas where many mothers were more up to date. < thinks of one in particular>

Me? I'd like to see a service which recognises that parents are the experts in their own lives. Some will want HV input and some won't, I'd like to see that respected. I'd like to focus properly on those who will most benefit from my input and I want to build up a good relationship so we can work in partnership together in order to help achieve whatever health outcome a parent wants to reach. I want time to support parents who are depressed, experiencing feeding difficulties or who otherwise need time.

Or is that too much to ask ?

anxiouselephant i HAD post natal psychosis after the birth of ds4 and my hv missed it! she failed to even to even do the edinburgh test with me and when i said to her quite clearly on at leat 3 occasions that i was not well, was not coping etc i was simply dismissed 'as a mother of 4 who knew what she was doing'! yes i had four kids but i had never even had post natal depression before, i KNEW something was wrong, i wasnt sleeping, i was seeing things, thoughts of harming myself and my children and yet i was ignored by the hv!

in the end my dp took me to the gp surgery who took one look at me, called in the emergeancy mental health team, who came round and then admitted me too a psych ward where i stayed for a week whilst they stabilised me on meds etc and then they continued to come and visit me at home, i got a home start volunteer assigned to me and a pscyh and cpn etc who all looked after me brilliantly. the hv was beyond useless.

DillyDallyDreaming - if only they were all like you it would be a brilliant service, it really would. I don't know how to achieve it, but I do know it needs to be achieved (or close to) or otherwise, you are right, it would be better not to exist.

4madboys - another example of how much damage HV's can do, she delayed you getting the treatment you would have got through your GP if you hadn't had a HV. It's not that the vast majority are just a waste of time, it's that there's a significant percentage of them actually doing damage.

i never cared about how much weight my DD was putting on tbh. did me good, no stress but she was nearly 10 lbs when she was born at 42 weeks so maybe its different?