Will health nurse intervene if lactivist refuses to supplement?

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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?

Just to add that it isn't uncommon for a child with SN to have feeding issues.

It's likely that was what was happening and your friend wanted to stick with BF.

@Allergictoironing Thank you! And spot on. I thought what I said made sense but it seems people have decided to make assumptions about me. I called her a lactivist because of the reasons I outlined above (incidentally she ALSO calls herself a lactivist), and because it conveys how steadfast she is in her position.

“Lactivist”

Hmm.

LEM I’m still breastfeeding at 22 months and the only way I managed beyond a week was by supplementing with formula, because my DS’s jaundice was so bad that he lost 13% of his birth weight in the first week. I felt awful about doing it at the time but I’m so glad I did it now, otherwise our BFing would have ended long ago.

The child could have other issues which mean they are not gaining weight how they should be. I'd be very annoyed if I was guilted out of BF only to find I'm now giving a baby with some digestive issue of some sort harsh cows milk instead of BM when I could have continued to BF exclusively.

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

Ah the drip feed.

Some medical professionals are not particularly breastfeeding advocates - they get worried for no reason. As long as a baby is feeding 10x + per day for as long as they want on demand and they have plenty of wet nappies then they are getting enough, they gain weight slower than bottle fed and the charts (which are old) are based on formula fed babies.

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

No. It makes you an arsehole. And probably a mythical arsehole at that.

I had my hv and doctor suggest using formula, they simply suggest it as it's easier for them to ensure they have no liability. Very few women are unable to breastfeed. My babies were small, I was small - they are adults now!

@trollbuster Thank you for your considered reply. It sounds like you’re in the profession so it’s good to have your insight. I find it odd that this mother refused to take her baby to hospital against medical advice so I hope she was exaggerating when she said that. Also agree the 99% statistic is baseless.

@BertrandRussell Yeah, she is an arsehole. But not all arseholes are mythical. Clearly.

Not all arseholes are mythical. But ones that “chant breast is best” are!

Also people exaggerate. Oh my kid was so ill they were nearly hospitalised. Reality - GP says temperature is high, but just give some calpol. Parent - but what happens of their temperature gets to x? GP - Well if that happened we might look at sending you to hospital, but I am sure calpol, etc will bring their temperature down.

Seriously?! So you believe I’ve totally made that up, do you? Have you never heard “breast is best”?

@jennymanara True. Hopefully she’s just exaggerating these things.

But hospital doesn’t actually always achieve anything.... especially if they’re just continuing to monitor !

Honestly the pressure they can put you under despite baby feeding well is immense

The child could have other issues which mean they are not gaining weight how they should be. I'd be very annoyed if I was guilted out of BF only to find I'm now giving a baby with some digestive issue of some sort harsh cows milk instead of BM when I could have continued to BF exclusively.

This was me. A family history of infantile ftt, combined with young diagnoses of lactose intolerance and cmpa, and easy weight regain once on solids. I had serious concerns about my babies health and was hospitalised twice. But I wasn't giving formula until there was a plan for assessing whether it would help my baby, because if there are digestive issues it may well make them worse. The line the hospital took was that all babies can be force fed formula and this will always cause weight gain which is the only thing that matters. So yes I ignored medical advice, because I wasn't prepared to risk my already underweight baby getting worse.

In answer to the OP the paediatrician threatened SS, but he never followed through.

I have my issues with the breast is best message but that's not the issue here OP. If this person wants to BF then she should be given the support to do so. Many people are very quick to say "just switch to formula" and you do have to be strong willed to resist this.

It may be easier for her to establish BF in her own home than in the poor quality hospital environment she would have to stay on.

I would say you definitely don't know the full story OP. A lot of health professionals are absolutely militant about growth curves and will suggest formula top ups to literally anyone. It's perfectly normal for a BF baby to poo once a week or even less. Maybe she's exaggerating to make herself seem even more dedicated to BF, rather than endangering her children.

Incidentally both of mine were topped up as newborns due to severe jaundice but have successfully fed for 2 years each so i'm pro top ups but some people don't need or want to and that's ok too. I know loads of kids who were apparently starving as newborns but are now just naturally slim/small very bright, sporty 5 year olds. Others caught up and are now giants.

Apologies to derail the thread but I'm genuinely just curious about this. My baby had jaundice and needed phototherapy but topping up with formula was not mentioned at the hospital. I was encouraged to top up with syringes of expressed milk after every feed, or in place of the many feeds that she was too sleepy for. She wasn't reweighed until day 5. Was the procedure at my hospital unusual because it seems like jaundice often means formula top ups. I'm sure it's not a big deal either way and I'm really not trying to be goady but I'm really just curious how the protocol works - does anyone know? My hospital experience in general was very mixed btw.

So much judgement dripping from the op - really bit what your friend needs when she's dealing with a breastfeeding newborn. I hope you can find a way to support her

@xtinak Not sure, but mine was a bit jaundiced as well. Formula wasn’t mentioned and I was told to just put him by the window to get some sunlight. Otherwise no real alarm raised by the hospital.

The babies stomach is the size of a marble at that stage. It takes the finest bit to fill it up. Loosing weight at the start is also normal, breastfeed babies on average do have a drop in weight after birth. She has clearly been talking to doctors and other health professionals about it and not just ignoring it.
I agree with everyone else, you seem to love the idea of this woman being a bad mum and 'causing' her first child's SEN with her poor breastfeeding (despite absolutely not evidence at all to point to this). Best you just leave them alone.

It really depends on the whole clinical picture. Age of baby, weight gain or loss, how often they are pooing, colour and consistency of stool, how many wet nappies, any additional health need etc.

Breastfed newborns should poo daily. Not all do but the vast majority will. Once they are 4-5 weeks, they begin to poo less.

Jaundice can make babies harder to feed as they are often sleepy. The advice is to feed regularly at least every three hours. No need to top up with formula, breastmilk is fine. Breastfeeding jaundice is also pretty common and nothing to worry about but routine bloods are required after 21 days if still yellow.

In answer to your question, the midwives will be monitoring. If they were concerned the baby's health needs were not being met by the mum they would discuss this first, then refer to social services if required. Breastfeeding can be difficult to get going. Women need lots of support that can be difficult to find.

If her first child is delayed/ has some issues, this could be what was effecting feeding but the issues were not obvious at this point aside from poor weight gain.

@xtinak My DD was re-admitted with severe jaundice and weight loss on day 5. We didn't realise that I had no milk yet and she wasn't feeding nearly enough. The midwife looked at her and sent us straight to A&E. By this point she was too sleepy to latch on at all. She was in the special care baby unit in an incubator under full blue lamps for 4 days and had to be fed a certain volume of milk on a 3-hour schedule to flush the jaundice toxins out. If the jaundice is above a certain level there is a risk of brain damage so they can't take chances with allowing you to EBF. My milk supply came in really slowly and I expressed like a maniac and added the tiny little bits of my milk to the bottles. They let me do a bit of skin to skin but she really needed the light therapy. I eventually got her to latch again around day 11 with the help of a lactation consultant.

DS was topped up from birth as I really wanted to avoid the same happening and he didn't lost much weight but still had to be re-admitted on day 5 for light therapy and they asked us to keep the formula top ups going until at least week 3, at which point I phased them out.