How would you approach this? HV!

[StarlightWithAsteroid]

Had HV visit for first time since Ds born. She said she was a student HV.

She was lovely. Really lovely. Gave us lots of helpful information on services in the area as we've just moved. She also appeared a little bit nervous perhaps. She asked about the birth etc. did her screening questions - whatever and showed genuine interest in the homebirth (not common here) commenting that she'd had a c/s whilst adding quickly that she wasn't too posh to push.

She was also genuinely interested (but unable to help) with my attempts to get a freezer installed in the local children's centre for me to store donated BM stating that she'd never come across that before and offered to do some research.

Anyway, when it came to the feeding discussion she went all bonkers.

She asked me how long he was going in between feeds, which really isn't long. She offered a solution to something I hadn't actually defined as a problem and suggested I stop switch feeding and keep him on one breast longer. She said that the flutter-feeding when he appears to be asleep should be continued as long as possible because that is a sign that he is 'licking' the creamier milk rather than 'drinking' the liquid. I was too stunned to reply anything other than 'okay'.

Yes, I see what you mean tiktok- I think perhaps Unicef is labelling something as flutter sucking when others are talking about that quivery lip shaking thing that babies do (non nutritive sucking?).

I think I'm getting myself tied up in knots anyway, so I'll just go and pour myself some .

I thought I'd been quite kind about the HV in my OP!?

Okay, so perhaps when she next comes I'll tell her I researched what she told me further and have found some conflicting advice/research etc. And give it to her.

What simple, cheap, thin book could I refer her to?

Isn't what she is saying about the end of feed suckling pattern right though?

I had my UNICEF update the other day and the bf coordinator was also reminding us about the usual feeding patter of - fast short suckles, then suck suck, swallow pause, then 'fluttter' feeding where the baby draws what is believed to be very high fat milk from the almost stripped breast. I've heard mothers describe it as kissing, licking, nibbling - and when my own did it it felt like trembling.

I always thought this was so?

We are currently training for baby friendly stage 2 and the training was taken off straight the UNICEF training site.

G;ad all is going well for you with new bubba

Well she was definitely wrong about seeing feeding frequently as a problem. I had the same sort of thing happen to me: I mentioned to HV that DS sleeps in OU bed (only 4 months old) and she started making suggestions about how to get him to sleep in his cot. I didn't have the courage to say "Erm...actually..."

mosschops30 Why is giving out incorrect advice ok? Is it EVER ok for anyone in ANY profession to give out incorrect advice?

All the advice I have been given is to feed from one breast each feed an donly offer the other breast if Baby seems to want more. This advice was given by Breastfeeding Network www.breastfeedingnetwork.org.uk/, midwives and health visitors as well as most websites I've seen. the idea being that the Baby gets the watery foremilk first followed by the full cream stuff.
I have been exclusively breastfeeding George like this for 6 months. he has gone from a low birth weight 9th centile to 50th centile all on booby juice so hasn't done him any harm. I would say Health Visitor was just offering you current advice which it's obviously up to you to decide whether to take or not.

I'm sorry, but I really can't see what is wrong with her advice. My dd had colic due to lactose intolerance, which was far better when she only fed from one breast at each feed, and only swapping if I was empty. That is not block feeding. Block feeding is only feeding from one breast in a given time period, regardless of how many feeds they have in that time. Dd fed around every 2.5hours at first and I would change breasts each time. I never got blocked ducts or mastitis. I always thought the fluttering thing was getting the hind milk too.

How is it wrong and disgraceful? Enlighten me? Only feeding from one breast, or letting them stay on and do the flutter thing?!

I'm confused too. I was told only one breast per feed to make sure they got the fatty cream at the end. Other breast if still hungry.

I'm totally confused!!

I have just had ds and was told this same thing, he is 12 days old. I've had three midwives out, been to the doctors about him having a cold and been at a health visitor run bfc and all have them have said to offer only one breast at each feed.

I knew the stuff about block feeding being to reduce colic due to oversupply and switch feeding being recommended for sleepier babies and/or to stimulate supply as I'd had this discussed with me when last ds was a baby but I assumed that advice must have changed? I am confused now! What should I be doing?

Thunks and gnocci,

I think it is fairly uncontroversial to say that you've been given poor advice. By all means allow the feed to go on into sleepy/fluttery/slower mode whatever it is we are discussing but ALWAYS offer the other side afterwards. Don't stick to just one side per feed.

Huh. Well you learn something new every day. I only breastfed dd to 12 months with no problems, but obviously I was doing it all wrong. Every single source or professional I have come across has said to empty one breast first. But mn says otherwise apparently. Isn't it more damaging for women to come on here, who are managing perfectly well feeding from 1 breast that every hv and bfc tells them and then be told that everyone is wrong? Isn't that more confusing? Won't that then breed an attitude of mistrust against the valuable help that hvs can offer? This place is weird sometimes.

There isn't a wrong way to breastfeed. But there are ways of doing it that can improve your chances of being successful, managing to cope with the demands, reduce damage to your nipples etc.

If you can do it a different way, you get away with it, your baby grows and it suits you better then that is great. But if you're not doing it 'optimally' you are increasing your chances of problems, not, I might add, guaranteeing them.

What is the problem with feeding from one breast fully first then? (Which is not the same as block feeding btw.) Sorry but it's just that noone has actually said yet, and I'd really like to understand better.

Nothing. Except there is no such thing as 'fully'. The flow might slow down. The baby might get tired and slow etc. but if he/she kept on going the milk would keep on coming.

It's probably most important in the early days that you give the other breast as much frequent stimulation as possible. Also, you can keep a bay feeding for longer by switching as the flow will be faster on the new breast.

Well just googled official Nhs advice and basically they say to feed from one breast to ensure the baby gets to the hind milk, then to switch breasts if necessary or start on the other breast at next feed. Which is what I was always told. And if switching breasts makes baby feed longer, surely the aim of that is to lessen intervals between feeds, which apparent is poor advice, and the op preferred to give short frequent feeds, but the health visitor was wrong for trying to help with this? Still don't get exactly what the hv did or said wrong, and think it is a shame to complain about her and potentially ruin her confidence and her career in its early stages? And she sounds lovely tbh.

For me if I had switched breasts frequently it would have been a disaster. I had over supply and dd had lactose intolerance. If I had just fed her the lactose rich foremilk that was abundant from both breasts and not let her get to the hindmilk she would have been in even more discomfort.

How is everyone on here who is certain that her advice is certainly wrong know this? What source do you get your information from, is it common knowledge or are you trained professionals? Just wondering how you can disagree with such authority on every bit of official advice out there. I'm not being confrontational, I'd just genuinely like to know as I seemed to have always got the same advice from professionals and I'd line to get it right next time if I've been told/doing the wrong thing.

Yes, Suddenley- I think that is exactly what Starlight saying too tbh.

-Offer one breast until the baby has had enough and then offer the other one. They may or not want any more, but the offer has been made.

I don't think anyone is advocating switching breasts at a set time or too frequently- just be led by the baby.

Agree Crikey - no one advocating all babies should switch sides at X minutes into a feed or that all mothers need to switch feed - be guided by baby and what baby wants/needs to eat.

If you routinely only offer one side at each feed you don't know if baby may want that little bit more that feeding from the other side would allow.

Also feeding one sided only means half the stimulation to the milk supply - after all each side only gets fed from every other feed, say baby fed roughly every 2 hours it could be over 4 hours between feeds on each side (L at 8-ish, R at 10-ish, L at 12-ish, R at 2-ish, etc) instead of every 2-ish hours. This might be fine for someone with a large storage capacity or very robust supply (large storage capacity is different from large cup size btw) but for a mother who's supply is more fragile (e.g. has been giving top ups or had a large PP blood loss or has hormonal issues like a thyroid problem or PCOS) this could be the death knell for bfing.

I am a bfing peer supporter, a bfing mother supporter (equal qualifications but from different orgs LLL/ABM) and a trainee bfing counsellor. I volunteer 2 times a week to provide support to mothers and I have OCD so spend far too much time researching things on line .

Ok I see what you're saying. That's basically what I thought.

This (co the brilliant Analytical Armadillo) is the problem with very prescriptive advice. Also that a lot of the info going around re foremilk/hindmilk is outdated - it used to be thought that there were two types of milk, this is not so. What actually happens is that between feeds, undissolved fat globules tend to stick or settle on the sides of the milk ducts, so if there is milk hanging around in the milk ducts, the very first milk which is coming out won't have been touching these. As the feed progresses more of them get dislodged/dissolve into the milk and so the fat content gets gradually higher. Kind of like a cup of tea where the sugar hasn't been stirred enough which gets gradually more sweet.

However if you don't stay on that breast long enough to get all of them, nothing happens to them, they still exist - they either get reabsorbed and replaced or they go into any new milk which is being produced. I would guess too that as you get further into breastfeeding and don't tend to store up milk between feeds that it all just ends up mixed in from the beginning.

It's not always necessary to offer the other side if baby seems satisfied with one, but it's also not so important to "finish" one side that you should ignore their cues, or take them off before they are ready. I know loads of people who have been told they must feed for at least X minutes or that they must do this or they must do that when in reality, follow your baby should be the only must and the rest are just suggestions.

xposted with everyone else :)

Don't want to rude suddenly but you keep changing your version every time someone says something convincingly because they clearly know more than you.
So first you thought the other side didn't need to be offered because of too much foremilk otherwise. Then, when people on here contradicted you, you researched it YOURSELF and found the same advice that we were giving on MN on the NHS website but still you tweaked it to make it sound like you were right?
Finally when truthsweet explained it properly you seem to have got it!! Yay!

So please don't say it's basically what you thought!
No it wasn't!

I think I was accidentally blockfeeding last week because I misunderstood this. My milk didn't come in til day 5 and ds2 wasn't gaining well so am guessing this was crap. I sort of intuitively changed to offering both by midweek and things have been better.

Where has this come from btw? I don't remember this being pushed last time with ds1 and he is only 2 so I thought it was updated advice.

Olimpia is there really any need?