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?

Weight gain is a tricky one. I have naturally small (dh and I are both pronouncedly on the small side of average, as are my MIL and my father, so the dc have two lots of genetic hits in that regard) and slow/gradual gaining children. I've exclusively bf all three (apart from four weeks of mixed feeding for the first at the beginning of his life due largely to botched post-natal bf support in hospital) and have had for all three various flappings around height and/or weight and even a dramatic diagnosis of FTT for the youngest who is just simply tiny (and has been from birth and is to this day at nearly 4) but developing excellently and the picture of health.
IME there is a collective anxiety in many HCPs about babies' weight gain, possibly partly due to historical experiences (when malnourished babies really were a thing) which have taken root in professional culture, almost certainly partly due to formula feeding culture having destroyed cultural confidence in bf. Fast weight gain continues to be celebrated in babies - I'm not at all saying it's a bad thing, as there are entirely healthy children at either extreme, but I think we are seeing so many very rapidly growing and gaining babies these days (a generation or two ago I doubt anyone would have batted an eyelid at mine) but haven't shifted our attitudes alongside. Then there is The Absolute Rule Of The Centile Chart.

What would worry me more are dry nappies (poos for excl bf babies don't have to happen every day beyond the neonatal stage) and especially any lethargy. If this is happening (and you actually know this, as opposed to surmising it), you do need to press her to get a second opinion/proper advice. Atm it does read as if you are putting two and two together and getting 27, especially about the older child.

Presumably she's engaging with health care professionals though, having her bs to weighed etc. She doesn't have to have her baby weighed, and absolutely no one would know her baby was underweight and advise her to take them to hospital.

Well if you’re concerned make a report to social services. They take things like the health of newborns very seriously, surprisingly.

Tbh I think you’re just trying to be as goady as possible to start a big hooha today (summer holidays after all) and this is just exaggerated hugely.

bullseye2018 what's your relationship to this woman whom you clearly dislike and have no respect for, yet who apparently shares intimate information with you?

@coconutpie @SnuggyBuggy So chanting “breast is best” and openly abusing women for using formula and calling them lazy and selfish doesn’t make you an activist?

How old is the baby?

This obviously isn’t about the child or you would be answering questions. You just want to slag off this woman and are using her child as a veil for your malicious dislike.

@CatteStreet 100% agree that there’s obsession with weight gain. In modern Britain if babies are starving it’s either neglect or a serious medical issue. But seems at least half of my friends were scared over weight gain myself included.

Not sure how I’m being goady. Or what my comments have to do with summer. Is my post not able to be taken on face value that I’m genuinely concerned about a child and am asking for people who know better than I do about whether there are enough checks in place to protect them? This is not a breast vs formula debate.

Topping up, with good support and a plan, doesn't have to lead to the end of bf, of course it doesn't. But in many cases it does, mainly due to lack of said support (I've done topping up with formula and ebm, it's a very demanding regime and if the dh/dp is not on board and other children need looking after and the MIL is around demanding to 'have a go' at feeding etc etc it can be very difficult to maintain) and plan. So while it can be incredibly useful, and there are mothers who mixed feed successfully for months, it's not a great idea to introduce it unwarranted, and the point people are making is that many HCPs will go to recommending/pushing formula at the slightest (or even no) indication that things may not be optimal. (And I have had the aggressive emotional blackmail 'do you want your baby to be OK or not?' when I timidly - shell-shocked from a very long-drawn-out birth and knowing there were other ways to deal with the situation - tried to suggest a different plan involving supplementing with only ebm).

Thanks to those who have commented on the actual question though. Much appreciated and I feel a bit less concerned now.

So report her to social services if you’re so genuinely concerned. It’s usually more helpful than posting on mumsnet.

You've not mentioned the this woman doing those things OP. There is nothing wrong with wanting to BF and being wary of the doctors who don't have good BF knowledge.

This is not a breast vs formula debate.

🙄

bullseye2018 no, posts are not always taken at face value. Nobody is obligated to do that. People are allowed to notice and comment on loaded language and read between the lines. People are allowed to ask questions. That's always how MN works.

If you don't want discussion just google, or ring social services yourself immediately if you genuinely believe that a baby is being deliberately malnourished or neglected.

Are you in the UK? When you were in contact with postnatal and infant health care services yourself were you monitored? We're checks in place in your experience? Is "health nurse" the usual title for the health care professional breastfeeding mothers are supported by in the region you live in?

Good nutrition in the first 2 years of life is vital for a child physical and mental development. This is tracked using growth. A period of poor growth can have life long consequences for the child. I have no idea if this could be the case for the child mentioned by OP, but just putting it out there that there is a well researched link between undernutrition and a range of negative outcomes.
Topping up with formula if recommended, or switching to formula if breastfeeding isn't working, shouldn't be seen as a failure.

WTF is a health nurse?

Imicola, agreed - but it's where that 'bf not working' line is drawn that is the issue here. And the definition of 'good growth' is not entirely absolute either. There are a whole lot of indicators alongside a growth curve on a chart that are indicative of good nutrition. As bf has a range of advantages some of which we don't fully know about yet, it would seem counterproductive to deny a child those advantages when the mother is willing due to an inappropriately low threshold of 'bf not working'/'baby not growing properly' - and this threshold is culturally too low almost everywhere due to various cultural anxieties around trusting bf and due to the formula companies having done very good work in the past.

Also why is it still so acceptable for HCPs to be poorly informed about BF?

I think the reason the OP called the mother a "Lactivist" and is concerned isn't so much that her view seems to be "breast is best", more that breast must be the ONLY nourishment whatever the circumstances. She isn't suggesting that the woman gives up BF, just that surely if the child isn't thriving then supplementary feeding could be considered.

@MustardScreams I don’t want to report her because I don’t want to trigger a world of pain for her. Especially because I’m only going by what the mother herself says. I’m asking because if it really is an issue I’m hoping it will be picked up.

@herculepoirot2 What questions haven’t I answered? If it’s the age question directly above your post I only just saw it. The baby is about a month old.

And for the question about how I know her, thought I had answered but I see I may not have. She’s a friend.

Anything else?

What is likely is that professionals were concerned about her baby, and were trying to frighten her into supplementing by talking about starving and hospitalisation. But things were not bad enough for SS to actually go to court and get a court order. The evidence threshold to do this is high.

Are you in the UK?

Mother's can refuse to see a HV etc, which means that it won't get picked up on.

But yes. SS intervention can be started for a 'general failure to thrive'. Later on down the line a cause of that faluire has to be identified or rather linked to the Parent.

In the case of very small bavies chances can't be taken, which is why we have these descriptions.

If you won't report it, i don't know what you want from this thread.