Told to stop BF - do I complain?

[cheezcurl]

Went to the emergency room tonight as I have mislayed my asthma inhaler and needed a prescription (seasonal so only use it a handful of times over July/Aug time). Nurse practitioner asked if I take antihistamines as they may help. I said I try not to take anything if I can avoid it as I am still BF. She told me "well she's 14 months dont you think its time to stop that now". I was a bit and told her that its recommended to continue until 2 yrs old. She told me that if she is eating "real" food there is no need and I should to stop. Know I am not unreasonable for feeling a bit taken aback, but should I lodge a complaint?

yes a polite complaint and send with it a copy of the DOH and WHO guidelines.

It is possible to take antihistimines and BF. You may want to contact the Breastfeeding Network. One of their counsellors is also a chemist. The BfN website has v good information pages on specific medications and breastfeeding. Yours may be listed.

I have no problems with antihistamines in general, I just try to avoid taking any meds unless I really need to. I did not think daily (she recommended) anti-hs were really called for although would be quite happy to take one occasionally when I'm really bad. I have consulted a pharmacist and confirmed that my anti-hs are BF-friendly. I just did not feel that taking the odd anti-h was reason to stop BF, or that she should be recommending that I stop. I also thought that being told to "stop all that" now she was on "real" food was a little patronising, she sounded like she was talking to a silly stubborn child. Maybe I was overly sensitive but I don't really think so as I am not that type of person and on the whole I have always had positive interactions with HV, GP etc wrt BF so not generally on the defensive.

erm, breastmilk is real food. that was patronising, it wasn't you being oversensitive.

some children (like one of mine) did not eat much at 14 months as weaning only got started at 13 months. Breastmilk was her real food. It turns out we found out when she was a bit older that she was allergic to diary and egg which is probably why her body refused solids till then.

what could she think? it was made in a laboratory?

Sorry - it's the patient advice and liaison service. Weblink here

cheezcurl what tone of voice did she use? Was it concerned/gentle/harsh/incredulous etc? (Sorry if you've mentioned this already).

The tone of her voice would be the key thing for me here. If she said it gently, sympathetically and not in a dictatorial way, making it sound like a suggestion rather than an order, I wouldn't complain. If, however, she made it sound as though she was telling you what to do, then I would be very annoyed (I didn't breastfeed either of my DCs by the way, but I believe 100% that you should BF for as long as you want to if it suits you and your child).

Ultimately, if you need the antihistamines more than your DD needs breastmilk, then perhaps YAB a little bit U, but I can see why you are if the lady was insensitive in telling you so!

Not sure I'd complain though. Purely because, having made a complaint to an NHS Trust about something recently (for "something" read "my 66-year-old mother dying while in their care from something that was totally preventable"), I can tell you first-hand that it will wind you up and make you very stressed, which is not what you need when you're breastfeeding and suffering from asthma/hayfever! However, that's another thread, and I don't want to hijack yours

I agree to complain, simply to make the point that hospital staff should be giving out advice in line with general policy (or more detailed patient requirements), and not allowing their own opinions / prejudices overrule that.
That applies to bf but also a load of other stuff. What if you had a consultant suggesting you try aromatherapy for a serious condition becuase it worked for him? Extreme example (and waiting for my jumping on) to illustrate my point - their advice should be evidence based or none at all.

I agree with Mummy Dragon

Hi Cheezcurl, you might be interested to know that some antihistamines don't work very well when taken as a one-off (some needed to be taken regularly to work a preventative effect), so it could be pointless, depending on what you take.

Your regular doctor or pharmacist will advise you, but as you don't like taking medication, you could save yourself from taking even the odd tablet if it's not really helping much. Hope this is useful.

I know that was a bit off the point of the original post, sorry if not required.

I would write an informative and 'sad and disappointed' letter rather than one of complaint. The nurse may well have been thinking of you, if you are visibly suffering, but I think an informative letter would do more good than an angry or patronising 'look what WHO says' sort of letter.

I think she was rather clumsy in making her point. I'm not sure you'd get anywhere with an official complaint.

Asthma can be very dangerous and she was probably thinking about it from a nurse practitioner's point of view rather than a mum's/health visitor's point of view - "The baby doesn't need milk but the mum needs to control her asthma."

I would say there's truth in this. 'Best' isn't the same as 'need' and the WHO guidelines are just that - guidelines. They are produced thinking about the whole of the world, including developing countries where there is more infectious disease, poorer quality food and less access to clean water. In a developed country there is much less 'need' for extended (hate using that word but couldn't think of another, sorry if it offends) breastfeeding and it is more of a choice.

Don't get me wrong, I feel strongly that it is an important choice you should be supported to make. But I suspect that the nurse practitioner was thinking something along the lines of what I said above and just didn't express herself well. She didn't actually say anything untrue - she did express her own opinion, it was this which was inappropriate.

If I were you I would carry on BF until your asthma/hayfever became a serious problem and then contemplate giving up so you could take anti-histamines, depends on your history. An asthma attack brought on by hayfever could actually kill you, she did have a duty to point this out to you, she just shouldn't have made the point by focusing on the breastfeeding and she should have actually told you why it is important you reduce your hayfever symptoms with medication.

I completely agree - breastfeeding beyond about 8months (IMO and nothing more!!) is a compromise between the mother's needs (medical and other) and the child's, and if this had come up as part of that discussion that would be one thing. But the comment was "well she's 14 months dont you think its time to stop that now" which to me sounds like generic advice she'd give to the mum of any 14mo.

She shouldn't have said what she did. But

The op turned up at a&e presumably having an asthma attack and needing treatment because she has chosen not to take preventative measures because she is breastfeeding.

At fourteen months this is a choice not a necessity. Therefore, given the nhs could well have to treat the op in the event of a serious attack brought on by the op's refusal to take steps to prevent such an attack, I don't think it's necessarily wrong to point out that by choosing to still breastfeed, the op is also choosing to put her own health at risk.

hmmm...good point - I didn't get from the OP that she was actually having an attck but then she wouldn't be in A&E...

Can't see what the nurse did wrong really. Her focus was on preventing the asthma rather then promoting BF in this instance.

I agree with Wannabe

A different way of looking at it and one that I would probably take is to wonder if she is giving out advice that I feel to be bad about one thing (ie the BF) then how can I trust any of the rest of her advice - how do I know that she is not just out of date or going with her personal feelings or wrong about something else (ie the asthma advice).

I don't know much about asthma apart from watching DH have it, but it does seem to be an area where new treatments emerge and they discover better ways of managing your condition, so the best practice recommendations made today are not the same as the best practice recommendations of 10 or 20 years ago. If I am being given what is effectively out of date advice for one thing, how do I know that everything else is going to be right?

hope you managed to get hold of an inhaler (and a spare for emergencies/keeping in the car etc!) and haven't had to use it too much!

No, I was not having an 'attack', I had a slight tightening of the chest (which is all I ever get, very mild and only in July/Aug). I could not find the inhaler that I had been given last year August (the last time I needed it)and my mother (who was with me) did not want me to wait until the next day for a prescription - just in case. As I had not seen an asthma nurse in the past year the nurse practitioner did not want to give me a new prescription without a check up (fair enough) and so requested that I come in.
Yes BF is a choice but I am not "putting my own health at risk by choosing to still BF", BF and asthma/allergy medication (especially in the case of such mild symptoms) are not mutually exclusive and she should know that. Her comment was based solely upon the age of my child, saying it was "time to stop all that" - cant you just hear the "nonsense" on the end of that sentence.
zipzap that was exactly what I said to my mum afterwards, being given what I feel is bad advice (even if not au fait with BF recommendations she should know that some meds are BF-friendly) does not fill me with confidence for any of her other advice/diagnoses.

Erm. OK. With all due respect: according to your last post, you had a mild asthma episode which you often get at this time of year. However, you lost the inhaler that a medical professional gave you last time this happened, even though you could reasonably expect it to happen again (this is implied in your post). Despite losing the inhaler, you haven't been to see an asthma nurse for a year. And you wonder why the A&E nurse spoke to you in a patronising manner?

And if BF and asthma/allergy medication are not mutually exclusive, as you say, then why didn't you take the allergy medication? (Your OP says "I said I try not to take anything if I can avoid it as I am still BF."). You're contradicting yourself now!

Admit it, you're just annoyed that she questioned your choice to breastfeed, which is fair enough, but don't kid yourself as to the reason why you're annoyed!

I hope your asthma is better now.

Can I just say that the nurse should not have expressed her own opinions about whether OP should be breastfeeding. This is not helpful advice.

It doesn't matter why OP was visiting A&E or what her choices re medication and BF are. The nurse should have stuck to advising her about her asthma.

That said, I'm not sure it's worthy of a formal complaint. I might be more likely to move on and forget about it but I can see why OP might feel it is important.

MummyDragon I only realised I had misplaced it when I looked for it the evening of the episode. I have never been to see an asthma nurse as I had not even heard of such a thing until the other evening when I was asked when I had last seen one. When I was prescribed the inhaler (last year for the first time) I was not directed to see one - I just used the inhaler a few times and then put it away and did not use it again... until the other night.
I am not contradicting myself, I do try not to take any meds as just because current opinion is that certain meds are okay it does not mean I want to take them unless absolutely necessary (tbh I feel this way about all medication BF or not!). When I had severe mastitis and concurrent tooth infection last year I took antibiotics... because I'm careful not stupid .
I honestly don't think I am annoyed that she questioned my choice to BF (by implying there was no benefit in it) as everyone is entitled to an opinion, but if someone else (not as opinionated and bolshy as I ) was already under pressure - from DH or MIL etc you know how these things can go - to stop feeding then being patronised by NP may be straw that breaks the camels back. It should be her place to support whatever choices a person makes where possible - at the very least within current guidelines.
I was undecided as to whether I should complain, which is why I started this post, and on the whole opinion is that I should. Thanks everyone.

OK sorry cheezcurl, it seemed as though you'd had the asthma problems for longer than a year ... Am now a bit on your behalf that you weren't advised to see an asthma nurse!

As I said originally, complaining is going to make things more stressful for you, as you are going to enter into correspondence with a hospital and they do not like admitting that they are wrong (in my experience anyway) so although it's fair enough that you are annoyed, do you really think there's any point in complaining? Even after I received a letter saying that certain practices would be changed, and staff training given, I do not believe that this will make any difference to what will actually happen on the ward in question, as I have seen the staff in action and they are bloody awful. I never received an apology either, as that would have amounted to an admission that they were wrong. Reading that letter still makes my blood boil.

Think of your emotional health over the next few weeks, not just today. (Yes, I know there's an argument for saying that this shouldn't happen to other women and that your complaint would be for the greater good. I'm just trying to be realistic).

x

Blimey, have had asthma (although like you cheezcurl, only very occasionally and related to hayfever or chest infections) for 15 years and have never heard of an asthma nurse. Will investigate.

Cheezcurl - I'd recommend you chat to PALS too. They were very helpful when we has some issues with my postnatal care at hospital and they said they would talk to the relevant area about our feedback. If you don't get much joy, then do complain. Otherwise, as you say, this woman's unsupportive attitude could really heap the pressure on someone already feeling got at about BF. And it was simply wrong of her to patronise you like that.

Meanwhile back in the none MN real world......not many folks DO breastfeed that long. Even health professionals may not have come across it and many will think WHO guidelines are there for third world countries to follow.

I'm not saying it's right but that's how it is. I wouldn't complain as i think the NHS are busy enough tbh.

Not everyone lives in a 'breastfeeding bubble'.

I know, you are right... who needs the stress! But I can't help but think that if everyone thought like that nothing would ever change. Oh well, we will see.