To think health visitors have a large part to play in obesity in the uk

[Superchop]

Yes I'm being unreasonable to do another health visitor thread
Yes I'm being unreasonable to group health visitors altogether I'm sure there are lovely proactive health visitors.
But...

I would argue there is a ridiculous emphasis on weight gains and loss for babies which causes mothers and fathers to obsess over milk and food intake. I think this pressure and concern from health visitors along with the graphs and centiles leads to over feeding and parents losing their basic instincts and common sense. I.e does my child look like they are healthy/ are they happy the majority of the time.

I'm willing to be told I am being unreasonable. I am not trying to be judgemental to those who use health visitors I personally ignored them and dc has only been weighed by the doctors and midwives at the check ups.
Interested to hear others opinions

When I had my Ds in '98, the advice to wean was at 16 weeks; I started at 14 weeks as I was returning to work soon after then and wanted Ds to be settled into that before I did. Prior to that, he was fully bf and gaining a lb a week at least. He was and still is very tall, lean and slim.
Dd was born in Dec '06 and by then the advice had changed to 6 months. I started at 25 weeks. Again fully bf baby. Again, was and still is tall, lean and very slim.

I have never had HV problems. They have all been great and very supportive (one in particular), though I did raise an eyebrow when Ds at about 2yrs old, the HV asked why he wasn't on 3 Weetabix for breakfast!

Incidentally, in the 60's a new mother was kept in hospital for two weeks after birth and with my brother, the nurse fed him Weetabix at a week old because 'he's a hungry baby'. Brother has had gut problems through his adult years post 30 years old, IBS being one of them and he always seems to have an 'upset stomach'. He fed his Ds Weetabix early for the same 'hungry baby' reason. It will be interesting to see if he has the same problems as an older adult.

I think Pretty has made very good points. When you get to be as old as me you will understand that guidelines change frequently and often go back to where they started. Scientific evidence only goes so far and is often contradicted by other scientific evidence. But everyone is different. Health visitors may well be good, bad or indifferent but as a body I don't think they are remotely responsible for obesity in adults.

Too much sugar in the form of gallons of fizzy juice, and too much salt in processed food, mixed with overly-protective helicopter parenting which discourages outdoor, unsupervised general running around and energy burning - that's more of a cause of childhood obesity than formula.

Health visitors don't make children obese.parents,careers,grandparents are responsible for nutrition
I didn't see a HV in my home beyond 6wk and then only at planned check ups

If people still can't make the link between eating too much (crappy) food / not exercising and getting fat I really fail to see how HVs can help them. It's not rocket science, is it?

Simply,if the number of calorie you ingest exceeds number calorie used,you gain weight
Nothing to do with HV.everything to do with diet people eat.
Incidentally, I see mn is sponsoring a kids sponge bar,www.barnyworld.co.uk/#barny.apparently it's a food you take anywhere on adventure...

I slighty get where you're coming from. My breastfed DS dropped from the 75th to the 9th percentile weightwise in his first four to five months, before settling around the 25th (where's he been ever since - he's now 2 years 8 months). The health visitors were - possibly quite rightly - very concerned and the whole thing has left me with lasting anxiety around his weight and appetite. Part of me accepts that he's just naturally thin and has a small appetite (both tendencies very much run in the family), but another part just wants to feed him up and envies more rotund toddlers!

But that's your issue,you weren't instructed to over feed

Well sm I think MN once had macdonalds adverts as well!

Where are the adverts for British farm produce? Seasonal veg? Why no ads for British apples? Pears?

You can't really advertise the good stuff because it doesn't come I a packet with a list of 'added ingredients'

I think the barny ad is preposterous.a biscuit/sponge bigged up a portable adventure
It's cake.nothing more less.its not a developmental stimulant
Mn is business and the ad will generate revenue,and site provide testers to have adventure with a re-packaged sponge

Actually I seem to remember that it has been said that formula can contribute to childhood obesity. It's to do with the fact that babies take much more formula than bm in a feed (as it is less nutrient dense), so their stomachs become used to being 'fuller' at the end of a meal. This then encourages larger portions as they are weaned as they are still hungry after a little portion.
But it's nothing at all as clear cut as 'formula makes babies fat'. A ff baby fed a healthy diet and smaller portions will always be slimmer than a bf baby weaned on a big mac and large fries .
Sad it's needed but to add a disclaimer - I have previously ff and bf children, I'm not a ff basher.

My dissertation is about childhood obesity and I working in HVing years ago disliked it intensely

OP has made a very, very good point but has slightly missed the emphasis.

Global strategies for tackling obesity are: breastfeeding, encouraging a healthy diet and increasing physical activity.

HV have a massive role to play, not just promotion of breast feeding but development of an attitude in parents around healthy diet.

The emphasis on weight, in terms of number is away from that point yes... Other factors such as general condition of the baby should be more important but it's a confident practitioner and parent who ignores the charts....

What HV should be encouraging is the recognition and following of babies cues in terms of being hungry... When top-ups or 3-4hrly feeds start being routinely advised or are advised with no real clinical need then the natural ability to know when you are hungry / full starts to get lost and that instinct is protective against obesity.

It's more likely to happen for formula fed babies as you can encourage a bottle feed easier than a breast feed, they take greater quantities and you can offer more calorific / heavier feeds in that volume - formula does not cause obesity but some of the feeding practices around formula can be a factor. Hence why feeding on demand / feeding cues led for formula is advocated and why you are advised to stick to the first milks for the first year.

Early weaning is another huge issue and all I will say is the advice is 6 months - the most important evidence is that the gut is unable to manage gluten under 6 months and various other foods can be problematic. The ability to handle solids in the mouth comes at different times too and actually spotting that development is as important as their 'age'.

Do HVs know this? They should, there is absolutely no excuse for not knowing it. It's not a secret - I am not a health professional these days and I can access it.
However, do HVs apply their experience and individual assessment of the need in front of them to that knowledge - yes they do... and that's not wrong but HVs see a snapshot of a life and we perhaps need to remember that with babies that advice is good for that short period of time before they develop / change again...

So yes OP HV has a huge responsibility towards improving obesity and emphasis should be feeding practices NOT weight.

It's not health visitors fault, but the concept of weekly weighing for all babies is just a waste of NHS time and money. And probably does start us off overly obsessed about weight.

When I had ds2 and was not well enough to get out the house with both of them the health visitor came to me to check and weigh him. When I was concerned re getting to the clinic, she said not to bother as he was on 50th percentile so no likelihood of weight concerns. But this same woman was running a drop-in with women coming weekly, I think they should all be told its not not necessary.

MN still has McDonald's adverts! It makes me and every time I see it!

Over 60% of adults are overweight/obese themselves. If adults are struggling to keep their own weight down, I would imagine plenty will also be struggling to keep their children's weight down too.

That's not something you can blame health visitors for.

And what's wrong with MN having McDonald's adverts?

I wish they had a great big flashing EVERYTHING IN MODERATION advert too. That way, the message might get through.

The adverts don't put food in our mouths, we do.

I'm just a total anti McD's person, that's all Worra and other people can eat what they want to. I just hate the ad's in your face for all these things.

I think you make a good point OP. If parents are drip fed from day 1 that weight gain is so very important, when do we expect to take that expectation to suddenly take a massive u-turn into "healthy eating is important".

When DD was a baby I can honestly say I was obsessed with her weight. I used to shake going to weigh ins in case she hadn't gained enough. It was very important she gained x amount of weight, I was constantly told. Now she's 15 months I've chilled out massively but do wonder if I'm supposed to still be fattening her up, and if so when do I stop? No one has ever given me a straight answer and I haven't weighed her in months

I don't think it's HV per se, but more like a confusing system they have to abide by where mixed messages about weight are given from a young age.

I do hate the ignorance of 'I only had my baby weighed by the midwife or doctor'!!! As if they are somehow superior!
WTF??????

HVs are trained nurses or midwives, who then do extra training to be a HV. Some come from areas such as A&E, ICU, cardiac etc.

I don't know any HVs who obsess about baby weight, its not healthy for parents.

Hmm 'everything in moderation' is not a useful message either tho. Everyone's moderation seems to vary

One cake a day
One biscuit a day
One choc bar a day
One pizza a day..... That's moderation, right? Just 'the one' is ok.... Didn't have two biscuits or cakes, stopped at one each, following just the one pizza...

YY HeySoulSister moderation is very subjective

It's always been the done thing to get your baby weighed though...it's the first thing people ask, or announce about a new baby. The first few weeks is all about the weight gain. Then the weaning is all about what and how much they eat.

Many parents in primary school prefer packed lunch so they "know what dc has eaten", or because they're convinced they won't eat at all if not given certain foods. Children are still praised for eating, told off or punished for refusing.

It's society's mindset that needs changing. I had a fab hv that really wanted to ditch the scales from clinic totally. He really tried to move away from the numbers and look at the whole baby instead. But parents were horrified, that's what they went to clinic for, they wouldn't leave without the mark on their chart, complained the hv wasn't doing a proper job.

Yabu babies need to gain weight to thrive constant snacking contributes to obesity have you seen the amount of snacks parents shovel into children it is ridiculous imo between that and processed food and little or no moving causes people to be fat

And you dont need to get babies weighed every week I didnt