Question for Mears or Tiktok or anyone who knows really - is it ever advised to give a bf baby water?

[WeaselMum]

I'm having an argument with NHS direct at the moment and would really value your comments.

The day after ds was born, I rang NHS direct (first big mistake - should have called the maternity ward or community midwife but anyway) to say he'd not had a wet nappy in about 8 hours though I'd been putting him to the breast regularly. To cut a long story short, the nurse I eventually spoke to declared "I didn't have any milk" and should not "even think about breastfeeding" but should give him as much water (in a bottle) as he would take and then call back. I did as they said, and when he eventually did urinate - I called back and they declared he was still probably "dangerously dehydrated" (though he had none of the symptoms they described and they knew this). Ended up in a dash to A&E and an overnight stay in the hospital where every nurse and doctor we saw said he was fine and the advice to give water had been wrong.

I complained and NHS Direct (or rather the local service they put me on to) are now saying that they should have advised to give him water AND breastfeed him.

I know they wanted to cover their backs by sending us to A&E but - I am convinced they should have directed us to an on-call midwife or doctor rather than scaring us to death and making me lose all confidence in bf after one day (I'm sure this is where I started hating it).

I am sure there is an element of my overreacting here so feel free to tell me so!! I feel better for having a bit of a rant anyway...

That was an unecessary trauma for you and I'm sorry you had to go through it. I wish people like NHS Direct would familiarise themselves with their limits and stop spouting crap to people. They should have passed you on to a breastfeeding support group.

Good luck with the feeding and I hope you get better advise and feel more confident soon.

No, I don't think so. The usual course of bfeeding means water's not needed. In fact, giving too much water to a little baby can be dangerous.

Also it interferes with the supply and demand element of building up a perfect milk supply to meet your baby's needs.

More info here

When ds was born 7 years ago, he advice at the time was not to give babies extra water to drink.

When a relatives grandson was born 2 years later, the mother was advised to offer occasional small drinks of water (just a drop in a bottle) which baby would reject if not thirsty anyway.

Now it seems that the advice has swung back to how it was 7 years ago.

Surley, offering small amounts of cooled boiled water isn't going to do any harm to a baby that is otherwise feeding well?

Bit from that link:

Offering water before the age of six months can pose significant health hazards.

Water supplementation increases the risk of malnutrition.
Displacing breastmilk with a fluid of little or no nutritional value can have a negative impact on an infant?s nutritional status, survival, growth, and development. Consumption of even small amounts of water or other liquids can fill an infant?s stomach and reduce the baby?s appetite for nutrient-rich breastmilk. Studies show that water supplementation before the age of six months can reduce breastmilk intake by up to 11 percent. Glucose water supplementation in the first week of life has been associated with greater weight loss and longer hospital stays.

Water supplementation increases the risk of illness.
Water and feeding implements are vehicles for the introduction of pathogens. Infants are at greater risk of exposure to diarrhea causing organisms, especially in environments with poor hygiene and sanitation. In the least developed countries, two in five people lack access to safe drinking water. Breastmilk ensures an infant?s access to an adequate and readily available supply of clean water.

Research in the Philippines confirms the benefits of exclusive breastfeeding and the harmful effect of early supplementation with non-nutritive liquids on diarrheal disease. Depending on age, an infant was two to three times more likely to experience diarrhea if water, teas, and herbal preparations were fed in addition to breastmilk than if the infant was exclusively breastfed.

Shocked about NHS direct BTW. feel quite sorry for you Weaselmum.

Mind you, I've never found the service to be of any help to our household.

Weasel, NHS Direct deserve a rocket.

Babies who are actually dangerously dehydrated need to be rehydrated carefully and under medical supervision.

A dry nappy for 8 hours on day 2 of a newborn's life is not a panic situation at all. It does indicate that the baby needs to bf effectively, and of course, as we know, giving any other fluids than breastmilk at this stage can undermine breastfeeding (and the confidence of the mum, which is exactly what happened to you).

If you had called a competent midwife (which is what NHS Direct shuld have told you to do) she would have listened to what was happening, encouraged you to express colostrum by hand and get it into your baby, and arranged for someone to see you very soon, so you could have been supported to bf effectively - just having the baby at the breast with his mouth open and moving a bit doesn't mean any milk/colostrum transfer is taking place. She would also have asked you to put a cloth or kitchen paper inside the nappy, as modern disposables slurp up the relatively small amounts of wee produced by a newborn in the first day or so, and it's hard to see if any has been passed.

You're right to feel very cross about this.

clumsy, the point is that the baby doesn't need the water. The advice has never been to give water to an otherwise bf baby - anyone who has said this in at least the past 20 years or so has not been reading the guidance properly.

No, I don't think the majority of bf babies in the UK will be harmed with small amounts of water, but it isn't needed, it can intefere with breastfeeding, and why on earth bother???

My instincts at the time were that this was all wrong - I should have listened to myself. You have given me the confidence to complain further - thank you.

Just as an aside, though the hospital staff were lovely, while I was there I asked to see someone for help with the feeding - and I saw a midwife who said that there was no technique to bf, and I should just keep putting him on the breast and it would be fine, and she didn't need to watch me feed - she was wrong too!

Man, I'm glad I'm not the only person...actually, I'm sad I'm not hte only person to have constantly requested help with BF and got 0! Grr. It's no good them turing up and watching you feed the side that "works" and buggering off just as baby goes mental when you try and offer side she wpn't feed on. Have total sympathy for you with people saying, Oh there's nothing to it, you're doing fine and leaving you feeling like a screwed up rag. RANT!

ali, I feel so bitter - when I was first in hospital constantly asking for help I got two student midwives who freely admitted they had no idea what to do - then I finally got him latched on with the help of a different midwife (using the ram his head into my boob approach)nearly 24 hours after he was born. Then I had the NHS direct experience. I was sick of asking for help and hating it anyway ...so it's no wonder I ended up ff - though I don't really want to blame others for my decision.

I have been telling every pregnant woman I know not to listen to anything their gp, mw or hv says about bf and to go straight to a bf counsellor or LLL - what I should have done myself!

Go back to the hospital to talk about their "support".

It will never get better unless people do this. I went back after I had DS1 and I'm about to go back after having DS2 and having a similarly poor experience (although for very different reasons).

you're right HM - I always intended to but other things took over - but I will not let it go.

It's taken me yonks to get round to it (DS2 is 8mo now), but I have to do this because I want bfeeding support to be better for the thousands of women who use the same maternity hospital as me.

I hate the fact that is so much about breast is best blar blar, and than very little help to get it up and going. I would have not got through the first few weeks without a bf counciler, i still speak to them even though ds is 5 months.

well - I have made various complaints and the Healthcare commission have got back to me

They have quoted the files that NHS Direct apparently use when someone calls regarding dehydration (and they will be sending me a copy, apparently)

the files say:

"instructions for dehydration - for newborns (0-3 months) offer water between regular feeding either formula or breast milk. If the mother of a breast fed baby is concerned about giving water between feeds she should consult her Health Visitor"

so they don't think they need to do anything more. They haven't even acknowledged the existence of the literature I referred to in my letter (kindly posted by hunker). Not sure where to go from here...

I explained that once ds was admitted that everyone we saw at the hospital disagreed with the NHS Direct advice - they say there is no complaint on file from the hospital so they won't investigate any further.

They ARE going to ask their advisors to be "made aware of the importance of effective and appropriate communication". So the woman who laughed and told me I wasn't "any good with babies" when I first rang will get told to be more sensitive

Weasel, well done for complaining, and boo hiss to NHS Direct who have not addressed your points at all, and whose advice and info is inappropriate and inadequate anyway.

I think you need to write back, and enclose copies of the correspondence to the head of midwifery.

Are you happy with their response? I'm sure that time might have made you less angry, but quite frankly that seems like a brush off. As for someone laughing at you and saying you are no good with babies!!!!!

thanks tiktok and jenn - no, I'm not happy with their response - I feel that my central point has not been addressed at all - yes they may be following their own guidelines but those guidelines appear to be at fault. I think I'm going to wait until I am sent this file and then gather lots more literature and repeat my point ad nauseam...