post HV review: need some reassurance, opinions MN'ers

[nachomama]

hmm, I do know how I feel really but "can I get a witness?" as they say where I'm from.

Had 9 month check yesterday (though he's just turned 10 mos). Unfortunately, just prior to this, he had a gastro-bug. Solids categorically refused for a week. Chronic diarrhoea for several days. We were worried for a few reasons; dr wasn't. He had lost weight- I already knew that would be the case. This was picked up at the review. But fortunately, the HV took this into account. Unfortunately, this made little difference with the effing growth charts. He is now on 25th centile, whereas he had been on 85th for first 2 months of life (though 50th at birth). So, his eating habits were under the microscope. DS baby-signs for milk (and now disrobes me if my response is too slow. HV says I should only be feeding him morning and night by this point. He evidently should also sleep through the night (never has, but I'm not bothered) because he should be getting all of his calories- from solids mostly during the day. We co-sleep, so I am fine with the night feeds (but I didn't even go there with HV, what she doesn't know won't hurt her) We are weaning for allergies and so he does not have the same diet as his lovely chubbier friends, which is why I am happy to demand feed. His diet won't always be restrictive- he's only just 10 months fgs. But the suggestion is I get his weight back up by stuffing him with high-fat foods: 2 puds a day was the specific recommendation. HV was actually very professional, nice even- just doing her job according to her training, I s'pose. But oh, it's got me down.

I believe in BF for him being the most important at this stage- it just has chipped my confidence a bit (especially as I had not caught up with sleep from DS's bout of unwellness). Also, I know that others have always had ideas about what I'm doing (MIL keeps talking about wanting to "fill him up", ie with solids) and this review just seems to support their views, not mine! I had a look on the WHO charts and LO is actually hovering at the 50th centile for BF babes. This put it in perspective for me. Temporarily. But I'd appreciate any comments from the MN community

HVs are useless at advise about BFing and weaning.
I wish we could all be brave enough to follow Moondogs approach, but I also find myself agreeing and nodding my head because it's easier that way.

BTW I'm still feeding DS the same as I did when he was just tiny even though he is now 15 months

your hv needs shooting.

someone bring me my rifle.

FUEGO!

I don't think I'm even turning up to my 8/9 month check because I don't want to have this conversation with our HV (who is bovine in the extreme)!

You sound like you are doing a bloody brilliant job. See if you can learn to look like this: next time. Or ask her how many fruit shoots you should be feeding your child to replace the breastmilk .

My DD is hated by the HV because she popped up from the 50th to the 91st centile. So you are damned either way I'm afraid. My DD is the height of a one year old (at six months). So my reasoning is that actually the charts only work if your baby is average and that there aren't a hell of a lot of average babies out there.

Which means us mums just get made to feel guilty needlessly

Y'know,our HVs are brilliant.So supportive of breastfeeding.I can't think that they ever actually wrote down the weight in those red book charts unless actually asked.

Moondog - your surgery must have the requirement to be a human being in the job description. Ours seems to have waived that. You are very lucky you know. I know some HVs are lovely. Mine is just horrid.

My new HV (we moved 3 yrs ago) is an ex midwife who regularly avoided her HV
that's why she became one...
She is so brilliant!

i ought to say that i have a clued up HV at the moment. (though i suspect she doesn't know enough about bf) she seemed totally human for dd's 2 yr check.

I could have written your entire post about three weeks ago! including the tummy bug just before HV inquisition. I succumbed and started lacing DS's food with cream and butter to try to appease the woman. DS is now being much pickier about food and started insisting on a diet of pure strawberry yoghurt whereas before he was up for anything. Came to my senses this morning and realised that I'm not actually trying to rear prize livestock, checked the WHO chart (50th centile)and reminded myself that there's an obesity epidemic in this country - myself included - and that's not the road I want DS to go down. Ignore her.

All the mums I have spoken to have been upset by the HV at the 9 month check - can't see why they do it myself. i've got a clued up HV who supports extended bf, co-sleeping, BLW etc as long as all the family are happy and healthy. She does not like the weight charts as she says that you can tell if a baby is thriving by how they are not how much they weigh

Anyway from my understanding lo should be getting 4 good feeds a day and it is really common for lo to need bm at night. Babies under about 2 'self regulate' so if fed on demand will eat what they need to gain the 'optimal' weight / size / muscle.

It sounds like we are doing similar things but luckily for me my little red book has the 'breast from birth' weight gain chart in so my lo looks like he is doing really well.

Hope you feel supported by all your MNers!

ok whomovedmychocolate, here goes:

what do you think, convincing? i'm just about ready to do battle.
fuego.

actually, i just had a thought- instead of a rifle kiskidee, i think the robots that fired shots out of their breasts in austin powers would be my weapon of choice. maybe instead of firing live ammo, they could fire pellets of useful information.

welliemum, if you're out there, do you have a link to the research you mentioned (feeding baby to "catch up" growth)? i've read through, like hundreds, of your threads and haven't found it.

i am considering making a leaflet in publisher entitled, "why we do what we do" (re: extended demand bf, co-sleeping, weaning for allergies, etc etc), cramming it full of facts and research, and just handing it to people who are interested enough to pass judgement on our approach with DS.

it would also help me if anyone had any research which showed that DS would benefit greatly from ME having 2 puddings a day

Please could someone direct me to the WHO charts mentioned in the OP. I would love to see some growth charts based on bf babies. I don't understand why they don't have seperate charts anyway, as bf and ff babies have typically different weight gain patterns.

Cazee, try the kellymom site re: charts page

It has a link to the WHO site with new charts, but also has standard growth charts with averages for BF babies plotted in red, as well as the WHO info. It also has some worthwhile things to bear in mind when dealing with growth charts. It's a great site for BFing mothers. HTH

Oops, sorry nacho, been away and just found your post.

Here's the abstract of the article. Basically saying that there are indications that stuffing smaller babies with cream buns to get them to be on a "better" centile is not a good plan.

Your leaflet sounds great! I think I'll do one about "why dd1 isn't allowed chocolate" (because staying up all night scratching her face off and crying really, really isn't a big treat for her).

------

J Pediatr Gastroenterol Nutr. 2006 Oct;43(4):428-32. Related Articles, Links

Rapid growth in infancy: balancing the interests of the child.

Weaver LT.

Division of Developmental Medicine, University of Glasgow, and Royal Hospital for Sick Children, Glasgow, Scotland. [email protected]

Low birth weight is associated with a number of immediate adverse consequences, and it has been assumed that "catch-up" growth is a "good thing" because "better" nutritional status is associated with greater childhood health and survival. The same thinking applies to infants who suffer malnutrition and growth faltering during weaning.

Recent studies suggest that the rapid postnatal growth of babies is associated with an enhanced risk for obesity, diabetes, hypertension, cardiovascular disease and osteopenia in later life. If this is true, it has implications for our recommendations for infant feeding.

Insights from evolutionary biology, life cycle theory, animal husbandry, epidemiology and comparative zoology suggest that the energetic feeding of underweight infants should be considered in the context of the whole life cycle and balance the interests of the child with its likely fortunes in adulthood.

Before we revise our current recommendations, we must consider the meaning of catch-up growth, what it involves in terms of tissues gained (fat, muscle and bone) and to what degree association represents causation.

In the meantime, it will be prudent to balance the short- and long-term interests of the child by endeavoring to (1) optimize maternal nutrition and health, to avoid low birth weight, (2) breast-feed ideally, (3) consider birth weight, gestation and future "nutritional environment" when making decisions about infant feeding, (4) use appropriate growth charts, (5) avoid excessive postnatal weight gain, (6) think about the whole life span and (7) extrapolate from animal studies cautiously.

ignore her. until they are 12 months milk is most important!! and even after this i would probably still let ds cut back on his feeds by himself.

thank you welliemum-

Well done you for feeding on demand still. It's an achievement to be applauded. Sometimes I wonder if HVs are at all educated or keep up to date with information.

Your milk will be providing your DS will so many nutrients still.

And take heart about the growth charts - they are for fatter, formula fed babies. Chubby babies are cute but it can also mean they've got loads more fat cells laid down which could indicate weight issues for later in life. There's pros and cons for each side.

Stick to your guns and keep on bfing if it suits you and your DS wants to. I'm still bfing my 25 months old DS and a new baby. Hard work but DS doesn't want to stop and even though my HV thinks I'll be one of those mums bfing when he's 8 (as if!), I don't care.

Well done you for being such a loving, attentive mum.