To be concerned at the number of people on MN second guessing doctors?

[Wolfgirrl]

Every day I read a new thread where the poster is canvassing opinion on whether to reject medical advice.

The most common seem to be wanting to refuse a caesarean/induction and not wanting to top up fail to thrive babies with formula.

I totally agree that everyone has the right to refuse medical treatment etc, but when it relates to a baby you're not just putting yourself at risk. It just seems selfish to me? Interested to hear other's opinions.

Yet I see a lot of posts from women saying they 'really really' dont want to try it. Why not? What is the worst that can happen?

It's linked to an increased risk of eczema, various allergies and asthma. Not to mention a whole host of other health conditions, including leukemia, obesity, cardiovascular disease in adulthood...

I imagine the women don't want to supplement with formula because it can prevent establishment of breastfeeding. Obviously, if breastfeeding isn't possible, formula is vastly superior to the alternative. Personally, I gave a bottle of formula at two days old because the baby was crying, I didn't know it was normal at this stage and was really worried about the baby being hungry (kind of wish I hadn't though, because introducing formula derived from cow's milk that early on has been linked to an increased risk of asthma and allergy). If I had any actual indication that the baby wasn't getting enough I would probably have supplemented with formula. But I do understand the reluctance if there's any doubt of it being absolutely necessary.

www.nhs.uk/conditions/pregnancy-and-baby/benefits-breastfeeding/

www.google.com/amp/s/www.unicef.org.uk/babyfriendly/news-and-research/baby-friendly-research/infant-health-research/infant-health-research-allergies/amp/

I listened to my obstetrician and midwife when they advised me to be induced at 40&5 due to high bp, and I formula feed my baby.
It never occurred to me to argue against the induction and why would I? It would of put myself and my baby’s health at risk.
I’m a critical care nurse, I know that doctors arnt always right, but they trained for a very long time to specialise in their field. Everyone makes mistakes and they can only provide advice on what they know and the information they have.

Why not? Why would you think there is a uniform answer to a question that depends so much on context and particulars? I assume that some people who refuse this on behalf of their children are assigning greater value to the possible risks of this type of nutrition (see post above) than you are, some are misinformed, some are irrational, some assign greater value to the benefits of the other choice (see post above) than you are, some are reasoning fallaciously about risk, some are refusing to think about it for psychological avoidance reasons, some are have had bad experience with medical professionals, etc.

You also assume the 'knowing' comes from an epistemically privileged position relating to special knowledge of oneself which is not accessible to doctors, but can then not be replicated on behalf of one's children. But why make this assumption? Perhaps this is how you deliberate, you are certain you have some epistemically robust insight into your wellbeing that escapes doctors, but none of this means that mothers cannot have the same insight into their children's well being (your claim to insight is as imaginary or as robust as their claim to insight on behalf of their children) or other factors aside from personal insight go into the decision. I have mentioned already quite a few times the subjective nature of risk assessments, a point you seem to be ignoring.

I constantly question my GP's decision and doing so saved my life. 2 drs and a nurse told me I didn't have skin cancer. I pushed and pushed until they finally tested and turns out I did.
For the most part I will listen to what they say but going with my gut has helped me on many occasions.

I’m not sure why you think the process of determining risk and preference would be any different because it relates to one’s child? In the same way somebody might make a different decision to that recommended by a HCP because they believe it to be in their best overall interest, so they do the same for their child.

As a pp mentioned, some people place heavy weight on studies that indicate exclusive breastfeeding confers lifelong health benefits, and so will go to great lengths to avoid top ups. This might be for a number of reasons, one example could be somebody who has severe asthma in the family and wishes fo do everything possible not to raise the risk of that any further for their child. I would personally place less weight on the studies as, in my view, the evidence is generally weaker than it is portrayed. I’ve yet to see a bf study showing a significant difference that isn’t confounded in some way. I would place making sure the baby gets adequate nutrition asap higher than thinking of the longer term risks, as I see them as low. Others weigh up that risk differently, as is their right. All of us believe we are acting in the best interests of ourselves and our children.

My question was more centred around women rejecting medical advice in pregnancy and on behalf of their children as it doesn't just affect them.

You're not a forced birther by chance are you, OP?

No.

I don't get why it makes any difference that the advice is on behalf of my child - the same issues with doctors still arise.

I questioned a GP who wanted me to take my child home - within an hour he was admitted to hospital and on oxygen. What's the difference between that and questioning the initial recommendation of an obstetrician re birth, or a midwife re formula feeding?

Parents standardly make medical decisions on behalf of their children and have to weigh up the same subjective risks. Parents are only challenged through the courts if they make outlandishly odd decisions against very definitive medical advice.

OP I have an underlying condition and I pointed out to the midwife her advice didn't apply to me on vitamins and medication. She told me to stop taking the stuff I was taking which was advised by doctors. She got cross when I challenged her and pointed out there was no issue with my vitamins and medication in pregnancy as this information was easy to look up.

I mentioned her advice to my GP. The midwife's advice resulted in 3 doctors time being wasted - I forgot another specialist urgently phoned to talk to me when I was at work.

I used the fact that midwife's clinic was at the other end of my borough and there were at least 7 community midwife clinics nearer to move to a different one.

Funny thing is I didn't have any disagreement with any of the other staff dealing with my antenatal care. I knew why they were being cautious. The care during labour and postnally from the hospital wasn't the best. However I had been advised by friends and neighbours to expect this.

The vast majority of health advice I’ve received has been poor. Last time I took my child to the GP with stomach pain so bad it was making him pass out I was sent away with a prescription for antibiotics for a non existent urine infection that he wasn’t tested for? 🤷🏼‍♀️

I’m not a doctor but I do work in healthcare and I see it quite often where a patient has diagnosed themselves and will not accept any other diagnosis or opinion.

I’m human just like my GP is and there are occasional times I have been incorrect but my advice is always based on the best available evidence at the time, it’s not just guessing!

I might swing for the next person who puts the word doctor in quotation marks too. The disrespect makes me so angry.

My GP’s (have quite a few at my gp surgery) were not fully understanding my thyroid function tests for a few years. I would be telling them I felt exhausted, low in mood etc and other symptoms and that I was confused by this and my T3/4 levels. It wasn’t until I saw a new GP who herself had the condition and could see I was being over medicated (slightly under and over can present with similar symptoms). She lowered my dose to 75mcg from 125mcg and pushed through an appointment with an endocrinologist consultant and my medication was put on the lowest dose (that 25mcg) and next appointment four months later I came off it

I am now off it completely with regular tests as the thyroid does fluctuate but I was over medicated for some time and felt absolutely awful.

Some conditions are very complex and many GP’s haven’t had the training required to understand the best way to manage them but unfortunately it’s difficult to get to see a consultant in some areas

And more specifically in situations where what the doctor is suggesting does not hold any seriously adverse outcomes if it doesn't work, e.g. giving a fail to thrive baby formula. Yet I see a lot of posts from women saying they 'really really' dont want to try it. Why not? What is the worst that can happen?

Formula is digested very differently from breastmilk. It affects the digestion rate and gut flora. It can interrupt the intricate mechanisms which ensure milk supply is regulated according to the baby's needs.

www.babycenter.com/0_5-things-you-didnt-know-about-formula-feeding_10357994.bc

As a pp said earlier, it can interfere with breastfeeding being established, and cause its own problems.

We tend to frame it in terms of 'benefits of breastmilk', but there is a pretty good argument for wording it in terms of 'risks of formula'.

FWIW a baby who is 'failing to thrive' should be seen by a pediatrician, it's a very rare condition.

I think it's ok to question them and if unsure seek a second opinion
After my hysterectomy I was sure I had a fistula after reading up on my symptoms , gp said I had a urine infection , in the end I rang the gp and demanded I was seen by consultant as I was positive I had a fistula and told him why etc , he agreed and yes I had one and had to have op to correct several months later and other treatment whilst waiting
I knew I didn't have just a urine infection but intially gp would not believe me so I did have to argue my case a little

Some conditions are very complex and many GP’s haven’t had the training required to understand the best way to manage them but unfortunately it’s difficult to get to see a consultant in some areas

This! A GP has a very broad knowledge of lots of conditions but may not know the specifics that a lot of people seem to want there and then. I think people (especially on here it seems) expect too much from them given the time and training that they have. A specialist will have only studied one particular area for years, GPs are not specialists and to expect them to be is ludicrous.

Can someone explain what cluster feeding is please ? Never heard the term when I breast fed mine ?

Ok I've read what cluster feeding is now just never gave it a name when I was BF ,

Struggling it's when they just feed for hours usually in the afternoon/evening and often before a growth spurt. It's thought to stimulate the mother to produce more milk, and does make some people who don't know about it think that they haven't got enough supply.

@ScrimpshawTheSecond

Er, no. There is actually a link between breastfeeding and allergies, but that never seems to be mentioned does it?

I am constantly amazed on here that people seem to completely forget that at the centre of this issue is a hungry baby. A real little human being, thirsty and hungry, sometimes for weeks as women go back and forth to breastfeeding groups, meetings with lactation specialists etc.

Yes breastmilk is negligibly superior, in the way organic food is. But if there was only non-organic food available, you wouldn't withhold it and let your older children starve would you?

I breastfed for 5 months but had no qualms giving my daughter a bottle at the beginning as we were getting it going. It went against my maternal instinct to see her upset and hungry.

I really do think that sometimes breastfeeding is about fulfilling the mother's ambition rather than helping the baby.

If you look on MN there are lots of fail to thrive posts, most from what I have seen including ebf babies whose mums dont want to give them formula.

'Er, no' to what, Wolfgirrl? I answered your question about why women often don't want to switch between breast and formula, especially in the early stages.

I'm not saying one is better or worse, I'm saying that there can be issues with combination feeding or introducing a bottle. This is not anecdotal; I'm conveying information that is based on evidence.

Allergies are not what I was talking about, I don't really understand why you've brought that up.

Anyway, I've no desire to get into an argument on the matter with you, there is plenty of sound research on these issues out there, if you really care to look into it.

Ok it’s clearer now OP. You are not in the least interested in how other people make medical decisions, you just want to do some BF bashing. It would have been better if you had clarified this at the start so I could have ignored you straight away rather than wasting my time.

Yes, indeed, Booboostwo. Tiresome.

There seems to be an agenda gradually being revealed as this thread goes on OP? My opinion is:

Sometimes doctors are wrong or are hopeless.

Some babies will be breastfed. Some will be formula fed. Some will be fed a mixture of both. If women want to bf and are happy with it and able to to do it that’s fine. If they don’t want to or can’t that’s also fine. If they want to combine both that is also fine. No mother should be pressured to feed her baby a particular way.