Will health nurse intervene if lactivist refuses to supplement?

[bullseye2018]

A mother I know refused to supplement with formula with her first despite lactation consultants and doctors insisting she did. She was even told to take her baby straight to hospital because it was "starving". She continued to refuse. The child seems okay some years later, but there are some delays and behavioural issues. There's nothing to say these are definitely related to the chronic malnourishment but who knows.

I find it difficult to believe the medical intervention ended there. Surely if she was repeatedly warned and told her child's weight was critical to the point where the baby should have been hospitalised there would have been follow ups?

She's now had a second child and the same thing is happening again, She wears her refusal to supplement like a badge of honour, but doesn't seem to realise no one is impressed.

AIBU to ask whether health nurses/doctors would really let this go when a child's health is at risk?

Anyone? I’m prepared to be flamed for being judgemental and told to stay out of it. I am staying out of it and am a big believer in live and let live, but just hoping (I guess) for some reassurance there are checks in place that will ensure this kid is not left to starve.

Genuinely low milk supply is really rare where mothers are feeding on demand,cwhich should be 14+ feds per day (2 hourly round the clock, usually more during "cluster feeding" in the evening) for as long as the baby wants each time during the first 3 months.

There are conditions which cause low supply even when genuinely feeding enough - diabetes and polycystic ovary syndrome can make milk production somewhat more problematic. Poor latch also means supply isn't stimulated and needs resolving. Some babies have health conditions meaning the baby can't latch properly to breastfeed.

I'm sure a health visitor should alert social services if a child was being starved regardless of why, but if a mother is determined to breastfeed and is feeding genuinely on demand with a good latch 99% of the time they'll have enough milk.

If the baby was seriously ill as a result you’d expect that social services would step in. She was probably lucky last time it didn’t reach that point.

I was once told my child was “starving” despite also giving formula - some health professionals are keen on the words.

If baby looses weight or drops significantly then I believe social services or the paediatrician can take steps to force mother into hospital for baby. I declined hospitalisation when I was offered it as stress will negatively affect milk supply, and the paed said that honestly all they would do is watch her feeding schedule and not do anything.

However, the fact they haven’t taken steps probably indicates that baby isn’t loosing / not gaining as seriously as you think? Obviously you know the baby, but mine looked an unhealthy little thing for ages despite formula. I do wish I’d never fallen into the formula trap as early as we did sometimes but as I’ve got a medical low supply I’m pleased I manage to breastfeed at all.

I would guess you don’t know the full details.

How do you know all this? If you are close enough to see that a baby is starving or “chronically malnourished”, you should ha e contacted SS yourself. If not, this is speculation.

This happened to me and as per protocol I was hospitalised with my DD (never mind that I’d just got over mastitis and was trying to establish breadt feeding. I was allowed to use my breadt milk, but had to syringe feed my child every 2 hours for 48 hours in hospital. I was literally on my knees - a feed started every two hours, not ending! It was the decision of junior drs over a weekend. By Sunday a consultant had come in and said look at the history of her children. They are jaundiced, smaller at birth but gain weight well at a certain point. He was great and just told me to carry on as I was.

FWIW, this happens with all 4 dc, once starting solids, they rapidly gained weight. The are now 7 to 12 years old. 2 are autistic (as is lots of dh and my family) all 4 exceeded expectations in all areas this year at school. Apart from literacy for one dc who has ASD and a problem with abstract language. Despite this, she received 108 on her SATS.

Protocol for breastfeeding is pretty regimented. Other factors, is baby alert, smiling, happy, periods of awake and asleep, are just as important.

Your use of the word 'lactivist' tells me everything I need to know.

I listed academic results to show that they were not chronically malnourished - they just didn’t meet some pro forma feeding/growth chart. When my dc were little, growth charts were based in formula fed babies, not BF ones!

@squeekywheel Which is?

Agree with squeaky wheel. Funny how the term "mother" isn't in your vocabulary, OP. Let me guess you formula fed your babies.

In response to some of the comments:

The mother is diabetic yet doesn’t look after herself, so if she does have low supply that could be why.

The baby has not been gaining weight and not soiling nappies like it should.

I know all this because the mother told me.

Yabu

Actual low supply is quite rare. Poor latch so insufficient milk is being transferred, a small mouth, sleepy baby due to jaundice or a prem baby without a suck reflex, not feeding baby often enough or for long enough are usually the causes of weight loss.

If someone wants to continue to breastfeed, topping up with formula is usually a spiral to stopping. Breastmilk is produced on a demand basis - the more you feed the more you make. Night feeds are especially important for this as it is when the most prolactin (the hormone responsible for upping breastmilk supply) is made. So when you start replacing breastmilk with formula your breasts think you don’t need as much milk and so make less.

There will be safeguarding in place if a mother refuses medical care for a newborn. The drs and lactation consultants she saw would have been able to make a report to social services who would have been in touch if Baby was in actual danger. Same with the current baby. They do not let sick babies die just because someone wants to breastfeed. So I doubt you know the whole story.

When my dd was a baby I was desperate to solely breastfeed. My milk didn't come through properly for the first week. I was admitted back to the baby unit where I was supported to breastfeed. BY SUPPLEMENTING FORMULA!! That was the only thing that kept us going to actually establish breast feeding. I managed to exclusively bf for a few months but then i got sick do I SUPPLEMENTED with formula. I was sad but i needed to put my dd's nutritional requirements before my own (and societal pressure) To try and do it alone. I used to feel more judgement from other women for FF out and about than BF. Fuck that - feed your baby the way that works for you. Either way is fine. I felt like a failure for not exclusively bf looking back i shouldn't have put myself through it

“there are some delays and behavioural issues. There's nothing to say these are definitely related to the chronic malnourishment but who knows.”

And you’ve not considered that you’ve got your cause and effect the wrong way round there?...

If she’s starving the baby it will be admitted to hospital and SS will hey involved.

In my experience many HCPs are quick to suggest formula well before babies are in the danger zone. I have friends whose BF journey failed due to early unnecessary formula supplementation.

@HatingTheBigShow I have used the word “mother” multiple times.

And your guess is wrong. I breastfed my child a lot longer than she hers and have never used formula.

I call her a lactivist because she believes women who don’t breastfeed are lazy and selfish. Her words, not mine. And she has openly abused women for not breastfeeding.

TheoriginalLEM that's not the issue here though - bullseye2018 wants support for her judgement of someone for breastfeeding. She wants to be told that a "health nurse" will make a breastfeeding mother give a baby formula. She's calling the mother a "lactivist" which is a word made up to beat breastfeeding women with...

I am interested in knowing what bullseye2018 's relationship to the mother and child is - ex?

Another in the "as soon as I saw lactivist, that's all I need to know". Stay out of it OP, that baby's mother does not need your unsupportive judgey crap to be dealing with.

I actually despise the word lactivist and even with your latest update, it still does not excuse you from using it. It's so derogatory.

Wanting to BF doesn't make her a lactivist. Most mothers over the course of human history BF their babies.

Again, OP, what is your role in this? This woman clearly isn’t a friend. If you cannot influence her to get help with her baby’s nutrition, you have no choice but to contact SS. Her “lactivism” is a red herring here. If she has told you the baby isn’t soiling nappies, the baby needs help.

@anothernotherone I don’t want support for my judgement. As stated I am concerned about the kid, but whatever makes you feel better about having a go at me...

I hate that topping up is seen as failure or a gateway to stopping. DS was tiny, severely tongue tied, my supply was genuinely low, perhaps due to preterm induction, PCOS, gestational diabetes or a delay in getting able to effectively feed until after his tongue tie snip after two weeks, expressing didn't really work for me. I felt horrendous having to top him up and the is a lot of judgement about it. After his tongue tie was dealt with by an amazing and supportive senior midwife we did get back to EBF and it was bloody hard work to get there. Now I'm preparing to go back to work/doing KIT days, I'm still unable to express, so some days he has to have a small bottle of formula when I'm at work. You know what I don't care topping up want the end of best feeding before and it won't be again. DS is healthy, active and robust. If there was less judgement and fatalism about combi feeding we might see more women breast feed for longer, and fewer women scared and seeing it as the inevitable end of BF.