whats the official advice re bf 12 month old please

[Confusedbreastfeedingmum]

DS2s one year check up today. All good except the health visitor was extremely negative about DS still breastfeeding 4 times a day (2 daytime, 2 night time). Im working on gradually dropping feeds. He eats solids really well, good weight etc.

She seemed to be really concerned that this was holding him back developmentally, esp as he is often fed to settle him at night rather than "self settling". This was all muddled with nutrition concerns so I couldn't get to the bottom of what the nutrition issue was. Is he getting too much milk? Is it no longer nutritious enough now he's older?

There were no other concerns to explain the discussion - healthy happy boy

The World Health Organisation recommends breastfeeding for two years. Ok, so not many people persist for that long but it can't possibly be harmful. There's another thread on here about crap advice from a HV - best thing to do is ignore it.

There's no issue, your health visitor is probably a dick. As long as your baby is also eating well it's perfect.

We just had our 1 year check and had similar (but put more nicely). Bottom line seems to be that after 1 main nutrients should be food but they should be having about half a pint of milk a day - this is any combination of breast, cows or formula (ideally not the latter according to my hv). She acknowledged that it's hard to tell how much they get from a breastfeed but suggested just 2 a day would be what to aim for. We do 1 in morning and 1 in evening and most days dd gets fed to sleep twice for naps, although she manages without at nursery or if we are out and about and she conks out in her pram/car seat and then seems to make up for it with cows milk. Suggest reading kellymom.com for some more pro-breastfeeding advice and all the stuff re feeding to sleep and nutrient value of breast milk. FWIW I would do what works for you, as long as you and baby are happy crack on with what you're doing.

Well, the World Health Organisation reckons children aged 12-24m should get up to a third of their energy intake from milk (see user-friendly kellymom link here.

If DS is well and happy, her concerns are likely to be misplaced (and uninformed).

Anecdotally, children breastfed on demand as infants appear to be no less independent or confident than their peers.

Self-settling is a useful skill, but not compulsory. You could look at extending your/his repertoire of sleep cues but that doesn't require weaning.

Good luck!

Your health visitor is an idiot. Carry on as long as you are happy. There's still plenty of nutrition to be had after one, and sleep is noone's business but your own - if you don't mind feeding overnight, then carry on. If you do, then night weaning is an option.

I still bf my 17mo, and it's seen us through various illnesses and currently teething. I have (attempted to) night wean, and I think it's improved sleep, but honestly I can't say that it wouldn't have happened anyway. I feed at least twice a day, and my child eats just fine. I think breastfeeding helps him to feel grounded after a busy day, especially after nursery - so the emotional benefits are enough for me to continue a while yet.

Unless your health visitor has put a lot of time and energy into researching this topic but has not got around to publishing yet so that every health department in the developed world including the WHO have time to catch up with her contribution to knowledge then it is fair to say simply she is very wrong.

What bollocks. Dd is still breastfed and she's bright as a button. She sleeps through now she's night weaned and had learnt to self settle at 9 months not that she ever did back then
We feed a bit haphazardly sometimes on demand, sometimes when I offer at bed or nap time and sometimes when I want to shut her up if she's cranky and calm her down. I can't stop really as she refuses cows milk so I'll keep going until I want to stop. Luckily no hv has ever said I need too as I'd probably laugh in their face.
Ignore!

Thanks. I have previously found kellymom helpful but I started to worry that perhaps I have got it wrong by referring only to strongly pro bf support.

HV and I got off on a terrible foot re sleeping but I didn't want to have missed something important because I was annoyed.

I bf ds1 for 2 years (glad to see that who approve!) and doing the same with ds2 who is 1 now. They have both had several feeds a day and have developed healthy appetites. Self settling is important only if its important to you. Otherwise children learn to do it in their own time. We had a fab hv who had worked in Africa, so was totally at ease with our different ways of going things. From what I've heard of other hvs, they give out very standardised monoculture advice which can't possibly suit every family. It doesn't even seem to reflect evidence based practise.

she is very wrong.
I think that some of the comments on here have been a bit harsh on the hv. I can hardly believe I'm saying this about a hv as I've always had rather a low opinion of them in general!! The op said that the hv concerns were not about bf a 1 year old which is clearly fine but the amount of milk that he's having. It really isn't ideal to have milk replace food at this age and having lots of milk aswell as food might cause to quick/much weight gain. Maybe that's all she meant??
The sleep issue however is surely only your business op. I'm fairly certain that your ds will self settle without milk eventually and when is entirely up to you!!

Nicky she was generally awful (and I've had a good experience previously) but you're right the frequency definitely concerned her. I couldn't get an idea of how much was right. Her answer was to work out how to "get him off me" and get more cows milk into his diet. Kellymom seems to suggest toddlers vary a lot in terms of how much they breastfeed and is generally quite relaxed.

I had been going to try and stop bf recently as I was tired but we've got into a very manageable routine whereby he also settles for DH without milk. I was actually quite relaxed about it until I saw her.

Seems odd to be concerned if he is eating well and isn't underweight. Plenty of toddlers bf.

Well at the risk of looking like an idiot I have just checked his weight (which HV said was fine) on the charts and he's on 9th centile, 75th height. So I guess maybe he does needs more food, less milk.

Double check with your GP. My dd has always been long and lean. The percentiles don't have to "match" for health (think marathon runners and rugby players!). Of course it's a good idea to get a check up but some people are like that.

Your answer is in her proposed solution. The idea that getting him of you in order to get more cows milk into him is so misconceived as to suggest that her whole approach is unprincipled and can be ignored.

BM is higher in calorie content than food so if you stop BF their is a chance that not only will he be less content, he may lose weight, there is also no guarantees it will cause him to eat more solid food either. Stopping BF just reduces one source of nutrition.

Sorry she was awful op - the reviews can be a bit of a nightmare. I certainly sat there waiting for a barrage of complaint. If you were relaxed before you should probably be relaxed now! I'm sure your baby's absolutely fine. If you're worried about his weight you could always do as pp suggested and check with gp but I doubt it's necessary- I don't think it's uncommon for the height and weight centiles not to "match".

That depends on the food bf1000 surely! I think that the recommendation not to replace food with milk is for babies well under one ie don't think that replacing a bf with carrot puree will help them sleep and fill them up. At one they eat anything. I'm fairly certain that my macaroni, broccoli, cauliflower in cheese sauce has more calories than milk.
I think it sounds like you've got a bit of a hv with regard to her advice about sleep and I'm about her idea of replacing bm with cows milks but there shouldn't be a problem in replacing bm with food during the day from one.