HVs...What is the most effective, yet kindest way to complain about a HV's shocking BFing advice?

[StarlightMcKenzie]

She told me my 7 month old should be on 3 breastfeeds a day after solids and at no other time. If he is hungry in between to offer him yoghurt or a snack.

I asked if she was sure of this as I had read widely and quite differently and she told me that this was fact. She offered me a sleep/feeding talk that would support this.

I would ask her to provide the clinical evidence of this.

I need to make a complaint to after struggling with continuos pain feeding and baby unable to duck at bottle at give months. She said she would look into it and call me to discuss. I received a note in the post saying there was nothing they could do to help me!

Well I doubt I will see her again tbh. I don't frequent the HV scene often. I just wanted to weigh my ds for the 3rd time since he was born.

There was quite a bit more actually. She asked me if I had been puting ds in his cot in the day time to get used to it and to play, and for daytime naps. I told her that I hadn't because he'd only just passed 6 months and the advice was not to leave them in the room alone. She told me I could have invested in a baby monitor, or just made a habbit of checking on him every 10 minutes.

Now I KNOW neither of these would make any difference to SIDS. Why doesn't she?

She also asked what he had for breakfast. I told her he has quite a bit of oats with fruit mixed in. She suggested I give him weetabix

I just ignored mine tbh. She told me that at 7 mths ds didn't need to feed after 7pm and he could just smell my milk which was waking him up

He's now 9 mths and I still feed him in the night, first thing, last thing and in between meals!

He'll let me know when he's ready to stop :)

Oh, and finally, she told me that to GET to the 3 feeds a day I had to drop one feed at a time .

I asked her how I would know he had dropped a feed as there is no pattern to his feeding? She replied that he mustn't just be allowed to feed when he wants to.

He's 7 months

When I said that I can't just leave him to be distressed and hungry she shrugged as if I was CHOSING to have a hungry baby.

BTW, I only even mentioned he was hugry during the night because SHE ASKED about the nights, not because I was asking for solutions. I wouldn't.

Very similar 'advice' was given to me by an HV when my DS had just turned seven months, so there's obviously some weird non-evidence-based guideline they're following. I was told he only needed two milk feeds a day (morning and evening) and that I should withhold BFs (starting that day, no gradual reduction about it) to make him hungrier for solids, plus use CC to get rid of all the nightfeeds cold turkey. Apparently doing these things would also make him sleep through the night.

I phoned the BfN group that work with that HV and they took her name. Dunno what the outcome was.

Go to the Trust's website and follow up on the How to complain link.
Write a polite letter stating the facts.
CC it into folk who know their stuff.
We have a fantastic MW/HV service here (as well as the other fantastic services you know about) and our lead MW (who incidentally has an OBE for services to breastfeeding mothers!) would have bene in there like a shot.

I know because I once emailed her about some absolute guff about breastfeeding we were told on a compulsory NHS training course.

Maybe chat to the infant feeding specialist at your local hospital?

I think HV should make a distinction between the advice they give for genuine health reasons - i.e. baby shouldn't be given salty food versus advice they give that's subjective parenting 'tips' that may or may not work for you and your baby. Because sometimes they give the latter perhaps trying to be helpful but end up making mums feel that if they don't follow it then they are doing things wrong. And of course the danger of hvs getting a reputation for giving out naff advice is that people then ignore genuinely important advice.

I've had a good exp with the hvs I've met so far - not so much with the gp. Though the friendly assistant I saw last week seemed to assume I was nervous about introducing solids despite me not saying I was. I can only assume that they don't see many 24week olds still ebf despite the advice! They were full of praise for him being a good weight on bm though which made me hope that no mum who had bf difficulties was listening.

My 8 month old has about 4 bf during the day and 100 5 during the night. He eats 3 hearty meals (one being weetabix - didn't know that was bad!). I thought most calories still came from the milk till they're about one?

LOL/ Nothing wrong with weetabix. It's just that I don't know why the HV suggested it as an alternative to oats?

I mean, I HATE oats personally, so maybe she does too and doesn't understand why anyone, let alone a 7month old would want it. But weetabix I'm sure is pretty good too!?

Thanks Moondog. I really will follow this up. I'm tempted to go to a 'talk' too just to check that they really are spouting the nonsense that this HV seemed to think they are, but I don't know if that is one battle I don't especially need, - with still a good number of battles on the horizon for things that directly affect our family iyswim. it might be a step too far.

We did also get the talk on breast feeding at the weaning talk recently - you should have apparently stopped feeding on demand before you wean as it makes planning or doing anything just to difficult! They should be on a four hour feeding routine!

Do you have my health visitor? Every time I get DS weighed, she quizzes me about milk/solids/sleep and then gives me a telling off for giving him milk and making him "lazy" or going to him in the night and "letting him wrap mummy round his little finger". If I asked for advice and tactics, I wouldn't mind, but she's reduced me to tears on more than one occasion and made me feel like I'm doing a rubbish job.

This link is great for spelling out the norms for a breast fed baby and why they don't take milk to the same schedule as a formula fed baby.

www.thealphaparent.com/2011/12/timeline-of-breastfed-baby.html?m=1

I'm trying to be kind, but I'm getting more cross on reflection.

She told me ds should be on 3 meals a day plus deserts and snacks by now. He has only just 'touched' 7 months and whilst he probably would eat all that (he's a hungry little muncher) I would be quite worried if he reduced his milk in favour of solids that his nappy show quite clearly he isn't yet digesting much.

(In fact I could probably pick the raisins out, give em a little wash and pop them right back into the box.)

So, is it that most people would have been weaning for 4 months by now, most people feed to shedule, most people have babies in their own rooms etc.? is THAT why?

Just trying to find an explanation. She seemed to be young-ish but also 'in charge' and was doing a performance review immedately afterwards apparently.

You don't have to fight another battle, merely pass it on to someone who can follow it up. So for that, as you well know, you need to get the basic facts of your conversation onto paper.

Ah yes. I'll write it down tonight.

The funniest thing (though not funny at the time as I felt stupid and misunderstood ) was when she said 'how do you KNOW he is asking for milk?'
and I was able to reply:

'He signs for it'.

She did the face.

Grrrrrrrrr

Thanks for posting this starlight, I recently had our out of hours doctor service telling me my 7 month old should be on 3 meals a day, it does undermine your confidence. But according to kelly mom website our babies should be on a maximum of 2 meals a day. I have also had loads of people telling me that babies only need 10 oz of milk a day at this age. It seems that HVs and Drs all give very different advice, some very out of date or just plain wrong.

Anyway I do think you should do something as these people are being paid to help us, they shouldnt be giving wrong or out of date information. If you don't want to complain could you just write a letter not naming any names but suggesting they let parents know about all the different schools of thought that are around on these subjects?

I think it's more her manner than the advice you are taking issue with here? Or maybe I'm way off the mark with what I've been doing? Between 7-9 months I think one should be aiming to get to three meals, 3 feeds, 2 snacks with all but morning feed being solids first? I think weetabix is fortified with vitamins where plain oats are not also?

I think it's more here that she gave you unsolicited advice and made yout like she knew it all, rather than than asking what you thought, how you feel about night feeds etc. she obviously has her spiel that she trots out to everyone she meets. The wrapped round finger thing is just rude and silly.

Maybe I'm out of date or misinformed but think carefully about how to word your complaint. Is it the info or the way it was it was delivered.

I thought food was fun till you're one and should always be given after milk. The NHS feeding booklet I got in October certainly indicated that.

You know when you go into weigh the baby you can do exactly that and then leave. I used to refuse to engage with them, we had the 12 month check up where they weighed and measured him, gave me a free toothbrush asked if I had any concerns I said no they said goodbye. They only go off on these tangents if you start them off or give them ammunition - like he signs for it. In that situation I would have said "I am his mother" and picked my bag up and left.

Oh and weetabix has both added salt and sugar which aren't present in oats and that's why they shouldn't be given to the under 1's at all.
Fortification with vitamins is a highly debatable benefit, we wee out most of it before it's even absorbed. Vitamins from fruit the body wants and needs and can deal with.

You are right about the weetabix! We eat ready brek over porridge due to the fortification thing though. It's got less salt than baby porridge and is cheaper. I see your point about weeing them out and I apply that reasoning to vits for self but think all things being equal may as well use the fortified just in case.

I think there can be a false dichotomy about these issues. All schools of thought suggest offering a variety of meals and snacks, unless you are offering milk immediately before solids (I leave an hour) all milk feeds become 'snacks.' So in that context I genuinely wondered if her advice was overly prescriptive rather than wrong per se?

I do think health visitor should be able to offer evidence, stick to guidelines, be collaborative rather than telling people off.

I do think suggesting breakfast before milk is mad. I can imagine a hungry dds attitude to sitting in her high chair, ravenous as I make breakfast. But then if you offer milk in between meals who is to say if they are after breakfast or before lunch?