Remember my vomiting toddler, the out of hours clinic and the advice to give him Ribena instead of breastmilk? Got a reply today to my letter of complaint.

[mawbroon]

And it is a load of bullshit.

here is my original thread

They are totally copping out of it by saying that the advice I was given is all as per the GP Notebook 2007 (an online resource for medical staff).

Re the Ribena thing, they said that the recommendation is to give 5mls orally every 5-10mins by syringe, increasing volume and frequency until 100ml is taken without vomiting. They said that the recommendation is diluting juice with water which could be of any brand, including Ribena and that this is a suitable alternative to breastmilk. But then they go on to say that the self same GP Notebook says that if a patient's illness is mild, there is no need to change the feed. "However it does state that breast feeding may be halted for up to 24 hours. It is accepted that most healthcare professionals would probably not advise to stop breastfeeding but I can confirm that advice you were given was not incorrect"

They also say that they have noted that this is inconsistent with the advice given out on the recorded message on the NHS24 helpline and will be discussing this with them.

What they don't address at all was my point that it is completely inconsistent with advice given by breastfeeding organisations such as LLL.

I want to take this further, and it does give the opportunity to arrange a meeting with someone about it, but I think I would feel out of my depth. Can anyone give me some pointers as to where I should take this now? I think I want to ask then WHY they think Ribena and rehydration salts are better than breastmilk, but feel I would only be met with "but that's what the GP notebook says". I don't give a flyingfeck what it says, I still think that in our particular case, the advice was crap!!!!!#

I have previewed this and all the apostrophes and quotation marks have come out funny. Sorry if it's confusing on the actual post!

Good idea smallwhitecat, but health is devolved so I would have to see who the appropriate person here would be in Scotland.

I have been fannying about trying to get a reply together about this and have decided just to bite the bullet and go and meet with the Clinical director to discuss it directly.

I am planning to take along a load of stuff supporting the idea that continuing breastfeeding is the best thing to do in this case, but don't just want to print off any old random stuff off the net. Can anybody point me in the direction of some properly sourced stuff that won't just be dismissed and will be taken seriously by the medical profession. The last thing I want is to come out of the meeting feeling like some neurotic mother....

Oooh! Now you mention it I was told that 'this might be a good time to give up bfing' when DS#1 had a runny tummy. He was only about a yr old and I had no intention of giving up. I gave him diarolyte as far I remember. But carried on with the bf.

No advice re materials to support your case, but the Cabinet Sec for Health here in Scotland is Nicola Sturgeon - and she might be good for rattling a few cags...

Good luck, I was to read this. I suspect the good old medical profession will continue to close ranks

*cages not cags

Got a call today saying that I can meet with the Clinical Director on 10th August which gives me plenty time to get some stuff together. I think the first thing I would like to ask her is the extent of her breastfeeding training so I can gauge if she is going to be talking shite or not.

I'd ring the LLL and NCT and so on to see what referenced advice they can give you. Kellymom is also good for actually quoting references for its advice too.

My way of doing it (used to be a tv researcher!) would be to ring the press office and say, do you know the right people in your organisation to contact, or other academics/medics who might be able to advise. They may also just have some basic fact sheets themselves.

But what I'd want, is to be able to go in and say, I have spoken to x who is an expert on breastfeeding, or LLL, or someone, and this is the latest, up-to-date advice, and they say that you are interpreting the GP Handbook badly.

I'd also put in an appeal on here for a science/medical person to help you get and interpret full details of the papers that you find, and generally translate them into normal persons langauge.

If there's anything I can do to help, let me know.

Um, and I've just looked at the GP notebook thing. Have they changed it recently, or are your health trust just manifestly as thick as a very thick thing?

Because when I looked at it just now, it says, commercial rehydration therapies should be used, it can be dangerous to use other solutions.

vonsudenfed, thanks for your help. I have called the local LLL leader but she hasn't got back to me. I think she must be away as she is one of my MSN contacts and hasn't been on there for a while either. I have also emailed the infant feeding advisor for the local nhs area but again, she hasn't got back to me either.

if you're not any further on in a few days time, CAT me and I'll see what I can do over a morning or so (am away the first week of August so would have to be sooner rather than later)

And yes, Kellymom is your friend. this page It says:

Breastfeeding should be the FIRST choice if your child can take anything by mouth. Because of the ease and rapidity with which breastmilk is digested, even if your child vomits or stools shortly after nursing, he will still have retained some of the nutrients. Other foods that are often suggested (such as Pedialyte, sports drinks, gelatins and sodas) offer little nutritional value and none of the antibodies that human milk contains.

...and has links to:

a) a who pdf www.who.int/child-adolescent-health/New_Publications/NUTRITION/WHO_CHD_97.8.PDF which says that "Mothers of older children with persistent dian-hoea should be encouraged to continue
and increase breastfeeding" (although this paper is about 'persistent' illness, i.e. for 14 days or more - and older children means over 6 months.

b) another study here says that withdrawal of breast feeding during diarrhoea was associated with a five times higher risk of dehydration compared with continuation of breast feeding during diarrhoea at home.

They are wrong beyond imagining.

I am familiar with Kellymom and use it a lot, but I am not sure if it is recognised IYSWIM. I am worried that I might get fobbed off with "well you can't believe everything you read on the net" or "that's an american site" or the like. But, I will print off as much as I possibly can so thanks for that

Sorry, didn't mean to lead you to the blindingly obvious, I just got rather over-excited at the medical references and WHO documents (have clearly missed work more than I thought...)

PMSL at getting overexcited at medical references and WHO docs!!

A couple of people in RL are saying I should just let this go, ds is fine etc etc and I can't believe that they are thinking it's ok for a "health professional" to be giving out such duff advice.

mmmm, facts. Lovely facts.

I know exactly what you mean about letting it go - and part of the reason I wanted to help is that I had a very similar experience with my hv, who gave me a ton of very stupid bf advice when dd was hving problems at the start. Now I'm only still bf only because I was a neurotic, middle class articulate mother that I a) had read around, including on here and b) got a second opinion from a bf helpine, and so didn't take what she said lying down. If I had done what she said, and replaced whole feeds with formula, I wouldn't still be bf now, and it infuriates me that there are probably loads of people here who have given up bf because of her.

And she has the cheek to congratulate me on still bf whenever she sees me.

Have you complained about her?

I think I will try to lead the conversation round to the general lack of breastfeeding knowledge by health professionals. Hah, here's me with all these ideas and she'll probably steamroller over me because I can be a bit reserved about speaking my mind sometimes.