Yet another moan at hvs

[hercules]

This is not about bottle v breast!

Got that out of the way.

I went to my baby clinic today as dd had some green poo and has been a bit unsettled. The hv said this was a sign of colic and I should give boiled water to her. Fine I said (not much help there then).
DD is nearly 5 months and the hv asked what her diet was and I said bm. HV said what is she eating so I said bm. HV what solids is she having as it must be her diet that is causing the colic, I said she isnt having solids.
HV had already weighed her and said her weight was fine etc etc. Now on hearing this re the solids she said she needs to be on solids as needs the calories. (DD has been in 6-9 months cloths since she was 4 months). I said doesnt the WHO recommend waiting until around 6 months. Not at all she said and the trusts policy is 4 months. The trust being the NHS. I asked why would the WHO and the government say 6 months then, they dont she said.
She then said i was doing really well to feed dd this long to which I said I fed ds for a lot longer. She was shocked and said didnt he bite you and did he mind this?? Like I forced him or something!
I said he bit once when he was 6 months old.
DD has been going through a stage of crying when anyone she doesnt know looks at her and when hv looked at her she burst in to tears. HV said Oh it's the colic, I said no it's because you looked at her.

Sorry for poor grammar and rambling. Feel much better know.
As a teacher I feel I have a duty to keep up to date with current recommendations so why dont HVs?
Surely there must be some rule about this?

Hercules, you have my full sympathy, similar things have happened to me; when I told my hv I was still bf dd at dd's 8 month check she was horrified and gave me a huge spiel about it being time I wasc starting with bottles. My solution with ds has been to keep as far away from said hv as possible.

Totally agree with you about the teacher bit; my hv didn't even know that there had been items in the news re: cot death, co-sleeping recently.

You know you're doing the right thing, just a pity you have to live with such ignorance.

I'm sure you know where to get information about the DoH policy on this, Herc.....and you have the courage to show it to your HV. I agree, it is poor that she has not kept up and nor has the trust she works for....it is almost a year since the UK guidance changed, and as infant feeding and weaning is one of the core strands of an HV's practice there is no excuse for being this far behind.

You could of course write to her supervisor/manager and express puzzlement at the trust policy.

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thanks for replies.
I wish I hadnt gone as I try to avoid such things but because of green stools thought I should.
I did think about writing to the manager of the surgery and now think i will do so.

I really truly despair with HV's. Shouldn't they be sent on some training courses to keep them updated? My brother's a nurse and he regularly has to do courses and study days. I can honestly say I have never had a good piece of advice from any of my HV's. I had real problems weaning dd onto solids (I also had trouble convincing them dd and I WANTED to continue breastfeeding until she was at least 1), and all my HV ever said was 'have you tried mashed potato?' Like a robot, she said this about everything. Dd had tonsillitis 'have you given her mashed potato to eat?' Dd started waking at night 'have you tried giving her mashed potato before bed?' I'm not joking! Maybe she worked on the side for 'Smash.'

lol evita

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And the strange thing is, dd LOVES every type of potato except mashed ...

ha ha at the mash! What are these HVs on?

I think a problem with HVs is that they work alone , and to a large extent, in private. No one hears what they say, and they don't hear what other people (maybe better people) say....and bad practice gets entrenched. Their contacts with other HVs are fairly limited, and it is hard for a 'good' HV to challenge what she knows is bad practice from another colleague. It is easier in a hospital situation for policies and guidelines to be monitored.

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I have an exceedingly good HV, and she didn't know about the WHO 6 month recommendations until I told her. She wasn't convinced, but we have a good relationship and she let me go on as I wanted. A few weeks later she told me that she had only just found out about the new recommendations for herself. Apparently there isn't any coherent way for all HVs to be informed of feeding policies. I think she was only 'officially' informed a few months after the rest of us were informed by the newspapers (and Mumsnet, of course).

Well, I spoke to ny local nhs trust who said that they are well aware of the "new2 guidelines and they did a presentation to hvs last year but of course it depended on who actually turned up to who knows iyswim.
They said that in the area I live in not many mums bf until 6 months anyway and some of those mums might struggle to do the weaning at 6 months hence they say ideally 6 months but can do at 4 months as so many mums will do it at 4 months regardless of what they say.
She was very surprised that my hv had never heard of the 6 month recommendation and is going to look into this particular clinics policy.

yes, I am a bfc, and we are required to show we are up to date ...I wasn't excusing HVs at all - I think their advice and info is appalling too often! Their supervision system needs to accomodate the working alone thing. GPs and breastfeeding can be a bit hit and miss, too.

The six month recommendation was in all the nursing, midwifery and health visiting journals. The CPHVA also informed all their members with a special mailing. It has appeared many times since.

Individual health service trusts may or may not have put stuff out locally.

If HVs are uninformed, it says a lot about their own reading of their own literature, and whether or not they talk to each other at all.

tiktok - this is a genuine question. If HV's and GP's are so useless on bf, how does anybody ever get referred to a bfc?

Good question prufrock, in fact how do we all manage to get so much info when our hv's are so useless? I think it must be from literature. Almost every pregnancy book now says how beneficial it is to b/f and contains phone numbers for b/f councillors etc. But then that makes me wonder again how hv's can be so clueless. I don't think it's the same as GP's as they have to keep up on information about thousands of medical things, but hv's are supposedly our primary source of information for things as crucial as feeding. I know there are some good ones, my friend has an amazing hv and I have frequently travelled miles to visit her to go and get some advice. She just seems genuinly interested and well informed. Heck, it is their job after all.

What I meant by the last sentence is that in my job I'd never get away with not being completely up to date with information. So how do they???

And how is it as a mom, working, no previous experience of kids, I seem to know more than my hv???

I'm ranting. Sorry.

Think I'll go make myself some mash.

Have to agree that it does seem pointless seeing hvs as thr ones i'e met have known less than I do.

Prufrock, most mothers refer themselves to a breastfeeding counsellor - at a guess off the top of my head I would say 90 per cent decide themselves to phone.

Also, sometimes GPs and HVs (and midwives) recognise a gap in their own knowledge and suggest the mother calls.

Why do they get away with it?

One reason is that mothers complain on an internet talk board, instead of complaining to the HV or to the HV's manager!

I was good here though and did take it further and is being looked into. I do agree Tiktok, I have to say I couldnt let this one lie although I am guilty of doing so in the past. Doe the health service not realise there is a problem ?
I was given a questionnaire from the hospital about my care there and included in it the lack of knowledge and poor advice given ie give her a bottle as she's hungry.

I know you did complain, Herc, and I sympathise with people who don't.....it can be hard to do so without being confrontational, and after all, you may be seeing your HV for some time, esp if you have another baby. It's not always easy to know who/where to write to if you want to go higher up, as well, though a call to the primary care trust HQ should inform you of the complaints procedure. Sometimes, you don't want to complain, esp if the HV is a nice person...you just want to point out where she's got it wrong. So in the end, it's easy enough to do nothing, and take the moan elsewhere

I once wrote a letter on behalf of a mother who'd been told by a breast specialist she had to stop breastfeeding totally, because of a breast abscess, and not to start again. She was told she could not bf with the antibiotics she was on. She was broken hearted at stopping, and mad as hell when she discovered weeks later she could have continued....neither she nor I wanted to make a formal complaint, though I wish we had, as the doctor never even replied to the letter.