argh! Crap bf advice in guardian.

[MoonFaceMamaaaaargh]

Sorry i can't link as i'm away and on mw phone but it's the "doctor, doctor" column on page 113 of yesterdays mag.

A lady who is struggling to bf a 1mo baby while looking after her toddler (who she bf for 11m) asking how the immunilogical benefits of bf will be affected as she plans to begin mixed feeding.

Dr Tom Smith begins "The immune benefits cross over in the first few weeks so you have done enough there already"

What is that supposed to mean? I genuinely do not understand what this is saying but the impression it gives me is that there is no immune benefit to bf after a few weeks? What? No antibodies?

He agree's that keeping some bf is good nutritionally...but offers no advice (or signposting) about how to mixed feed while not compromising supply. I would have though that would have been important this early on.

He does how ever suggest she might wish to consider expressing the bottle feeds as apparently "you can express far faster than your baby can suck." He says a mw or hv will advise on doing this efficiently...surely it isn't ever quicker to express, store, sterilise, bottle feed etc than just bf?.

No mention of trying a sling, that bf leaves a hand free to play with a toddler or that while you clean/make up bottles etc you are with neither child while you can be with both while bf... I'm not saying she should be pressured to bf, but just able to try making it easier before cutting back as it's a difficult decision to reverse.

Argh.

Think i might have to write in

Does anyone have suggestions for evidence i can site re immune benefits (or the rest) ?

As someone whose 9 month old DS is still EBF, there have been times when it has indeed been quicker for me to pump and for him to have a bottle of boob milk.

But I've always found expressing easy and fast, and my DS has generally taken a bottle very happily. And I've had support on hand from DP. That's not going to be the case for everyone.

My problem with the expressing part of Tom Smith's advice is that he says 'you can express far faster than you baby can suck' - as if that's just a universal truth for all women. Which as a piece of advice, absolutely sucks (ho ho).

I think people need to be careful though they don't fall into the reverse trap and say that all women express more slowly than a baby can suck.

Surely the truth is that the experience of expressing and feeding EBM in a bottle varies a lot according to individual women and babies. It will work for some, but others will struggle and it may not work at all for them (he doesn't even MENTION the huge issue of whether or not her baby will take a bottle in the first place, fgs. This forum has SO many posts from women whose largely BF babies just won't take bottles).

I agree with other posters that if Tom Smith wanted to go beyond the woman's initial question, which was about immune benefits, and talk about easier feeding options, the isolated advice to express and bottle feed was foolish. Lack of space isn't an excuse.

The immune system advice is quite simply wrong, and should be corrected.

My sister's a b/f counsellor. She gets plenty of calls from distressed women who have been given ridiculous and plain wrong 'advice' from their GPs. Including one whose baby had terrible colic every evening and had been told to cut out caffeine, chocolate, fruit and veg and a dozen other foods from her own diet... Some GPs (and HVs) are barking. They make stuff up and then pretend it is A Medical Fact. And they need to be challenged so they are stopped from causing real damage to women and babies.

No, moonface, mixed feeding didn't affect my supply thank you. I didn't introduce bottles until 6 months.

And it's not that unusual, actually, I've met a few people with a crap, slow supply. It really, really gets on my nerves when pro b/fing people spout how much easier and straightforward b/fing is than bottle feeding. It's NOT for all of us and it's really not helpful to peddle that "breastfeeding is so straightforward and quicky" stuff when for some people it really isn't.

Just for info moonface - you can put bottles in the dishwasher

Justventing.....please read the posts properly....the objection here is to incorrect facts being printed in a national newspaper, not mix feeding per se or to the choices you made for your family.

Um, please read my posts properly! I don't for one minute think the objection is to my choice to mix feed

I'm asking the OP to consider that she also shouldn't make sweeping statements about breastfeeding - I agree the Drs advice was incorrect. I just think the OP is also wrong to spread the myth that breastfeeding takes up less time than bottle feeding. Not in my case!

Not sure how you interpreted that as me being sensitive about my choices what a strange thing for you to say!

You can put bottles in a dishwasher if you have one

But i don't think any dishwasher can extract the milk from your breasts, bottle it, date it, get the oldest milk out, defrost or scald it if necessary, and put it in a clean bottle.

Again just venting, please read the entire sentence. As i pointed out above i an talking about the whole process of expressing to bottle feed. This is what has been suggested in the article to a woman wanting to mix feed in order to save time.

I have no doubt that some women find ff quicker than bf but i think it is very unusual for someone to find expressing to bottle feed saves them time.

I am happy to discuss criticisms of my posts but please can they be of things i have actually written.

Lol at the irony of you telling me to read the posts properly lizzytee.

Right, I'll spell it out for you.

This is what I object to:

"No mention of trying a sling, that bf leaves a hand free to play with a toddler or that while you clean/make up bottles etc you are with neither child while you can be with both while bf"

It took me approximately 5 mins to wash and microwave sterilise a bottle. Approx 2 more mins to make up a formula feed. And my toddler could be in the room, helping with these tasks. So I take issue with the fact that you say you can't spend time with a toddler while you prepare bottles. Plain wrong on your part.

Also - 7 mins spent preparing a bottle is nothing compared to 90 mins sitting glued to a sofa with only ONE hand free.

I object to the fact that you think you have a better idea of how restrictive breastfeeding is to the person who wrote the letter. Who are you to decide it's easier to entertain a toddler while glued to the sofa for an over an hour than it is to wash a bottle?

I just think you were expecting the Dr to mention something that PLAINLY WASN'T TRUE in my case.

I'm not going to argue about your personal feeding logistics just venting. I'm very glad it worked for you.

I was simply to make the point that he could have suggested ways that might make bf easier for her before she cut back. Obviously if they don't help her she would just mix feed as she is already considering.

I don't think giving out advice on the basis that some toddlers might like helping wash bottles would be very sound. The stuff you write about making up ff is redundant as i am talking about expressing, as is the doctor.

Hey, Justventing, remember that this woman has a 4wo and you say you didn't mix feed till your baby was 6mo, so you're not comparing like with like.

I agree that everyone's situations are different and I'm glad that you are happy with your decision to mix feed and that it worked well for you. Fwiw, I think there's not enough talked about it as an option that may enable some women to bf for longer.

I'm on the pragmatic, long view part of the breastfeeding support spectrum, if you like. I want all women to have access to the best evidence information, but I know that personal circumstances and preferences mean that not every woman will breastfeed in this generation.

However, talk kindly about it, encourage free debate and not belittling anybody's individual experience and we might see a different picture in the future, for our children.

Back-biting and slagging each other off does nowt to help anyone (speaking in general terms, not having a go at anyone on this thread!).

Dr Smith should have used the space he had to give good information. He didn't. Regardless of personal situation or experience of anyone else, is irrelevant to that fact - though I personally find them fascinating - I'm a bit of a personal experience addict and love to hear what works for other women as it informs what I do.

The thing is, if she'd asked for help and ideas about managing her toddler AND feeding, that would have been fine advice: slings are great, etc.

She said she PLANS to replace feeds and would the remaining feeds still convey immunological benefits? His fuck-up about 'having done enough' aside, the answer is yes and he said yes.

GPs are, I think, badly-trained in this aspect of public health (encouraging breastfeeding, giving accurate advice - v tricky and expert - and understanding the long-term benefits themselves) but they are actually required to be respectful of choices. If someone asks a specific question, it's not really ok to try to persuade them round to a particular viewpoint. And it is a viewpoint that exclusive breastfeeding is essential, one that not everyone shares. That's a different issue.

However it was irresponsible of him not to say that her supply could be seriously diminished, it would have been reasonable and responsible of him to point that out.

He fucked up about the immune benefits, fucked up about the efficiency of expressing and failed to mention anything about supply - was there anything good in his answer?

Justventing........really don't understand what irony you see in this., since I haven't disputed your experience of feeding your baby....so can we please play nice?

I think justventing, in a roundabout kind of a way, is trying to say - if the Dr needs to stick to the facts when giving out advice on b/fing, then so does everyone else.

Is that right?

And I don't understand why you brought her choices into it either tbh lizzytee.

What HBW said.

"Hey, Justventing, remember that this woman has a 4wo and you say you didn't mix feed till your baby was 6mo, so you're not comparing like with like."

I thought JVR was saying that she ebf until 6 months and her babies were still, at that stage feeding for 90 mins at a time. Presumably why bottles were introduced (have no idea though)

I still don't get why either lizzytee or howbreastfeeding works are bringing choices into it though. JVR quite clearly hasn't mentioned them. Where are you getting that from? To my eyes, she's talking about her expereiences not her choices.

Hey, Justventing, remember that this woman has a 4wo and you say you didn't mix feed till your baby was 6mo, so you're not comparing like with like.

I agree that everyone's situations are different and I'm glad that you are happy with your decision to mix feed and that it worked well for you. Fwiw, I think there's not enough talked about it as an option that may enable some women to bf for longer.

I'm on the pragmatic, long view part of the breastfeeding support spectrum, if you like. I want all women to have access to the best evidence information, but I know that personal circumstances and preferences mean that not every woman will breastfeed in this generation.

However, talk kindly about it, encourage free debate and not belittling anybody's individual experience and we might see a different picture in the future, for our children.

Back-biting and slagging each other off does nowt to help anyone (speaking in general terms, not having a go at anyone on this thread!).

Dr Smith should have used the space he had to give good information. He didn't. Regardless of personal situation or experience of anyone else, is irrelevant to that fact - though I personally find them fascinating - I'm a bit of a personal experience addict and love to hear what works for other women as it informs what I do.

Argh, stupid phone making me look mad by posting the same thing again - sorry!

Hi, audiconnection. I didn't mention choice? I think that there isn't as much choice in infant feeding as we are led to believe (and the figures back that up - with 90% of women who stopped bf before 6 weeks saying they would've liked to bf for longer). This being forced into feeding in a way we didn't envisage or want can cause very real, longterm sadness. That sadness can manifest in a number of ways. Some women want others to have better information and become passionate about that. Others shrug and get on with it. Still others actively seek to shut up and close out anyone who says something that hurts to hear about bf or about formula.

Bit of a tangent to the thread, forgive me!

No, he fucked about about 'having done enough' feeding to have passed on the immune benefits but then correctly said they would continue with some continued breastfeeding (so was illogical) and went on to suggest expressing, so breastmilk would have presumably taken the place of some or all of the planned formula feeds, ergo better than not expressing.

Recommending expressing makes no sense if it takes longer than feeding but rather a lot of you have assumed it does for everyone, and it doesn't for everyone: so that was a suggestion that would have worked for some and not all, ie not perfect, but not as useless as it's being spun here. It does however make some sense if you imagine that he knows breastmilk is the better option, he's been told the woman plans to use formula, he knows he can't say 'oh don't do that, breastmilk is better' because she hasn't asked for his advice, but he'd quite like to recommend something anyway.

It was a bad idea for him to have answered this question (and not to have answered it expertly), but what he said wasn't 100% bad, and it was nothing to do with slings or washing bottles or anything, so I'm not sure why those have been mentioned at all. How to continue exclusive breastfeeding and what to do with her toddler, one-handed or not, was none of his business in the context of the question asked.

Sorry, HBW, when you said "I'm glad that you are happy with your decision to mix feed and that it worked well for you" I assumed you were referring to her choice. I guess it was the word 'decision' that made me think that?

Got the impression JVR was talking about practicalities and not decisions. But hey ho, if you weren't talking about her choices then that's my misunderstanding.

He was incorrect in saying expressing is more efficient - if he had said it could be more efficient if the baby had problems feeding at the breast then it would have been more accurate. Recommending expressing isn't the problem, but giving poor information is.

Oh I think we agree that poor information is the problem
I don't know why I'm on this thread I just got cross that he was meant to have discussed lifestyle advice in a medical column.

Ah, yes, I see why you thought that. Semantics v important with this subject!

For me, a choice is an active, positive thing. A decision is more of a neutral word. I tend to refer to decisions rather than choices when I don't know the full story behind someone making that decision.

It may absolutely be that JV made a choice by those definitions - equally, it may have been the least worst option for her. Given the way she has posted (sorry, JV, for talking about you!), I'd probably opt for the former, but, linguistically, I always err in the side of caution. Some people say I overthink things