Feelign deflated after visit from HV

[rascal1979]

I have been posting for sometime on another thread about my stuggles with Breastfeeding my prem baby (born 9 weeks early).

Since leaving Nicu on her due date just over two weeks ago she has been feeding well - only from my right breast but the BF counsellor is fine with this at the moment until she is stronger and more established - and I have been feeling tons better. That was until today.

HV finally been to see us and has left me feeling

HV asked if DD was okay and if I was. Said yes that she was putting on 2oz a week and the BF co-ordinator is fine with this etc. He said that he isn't and would expect more gain. He said that DD should be feeding for 20 min each feed any less than that and she is only getting foremilk and won't gain as much. DD only feeds for 5-15 min max (about 10-12 times in 24hrs - 2-3hrs in the day and 3-4hrs at night). BF co-ordinator has said that DD will take what she wants and not to clock watch as this isn't reliable to what she is having. I have a fast letdown and good milk flow so she takes a fair amount quite easily.

He was talking about topping up with EBM or formula if she is failing to thrive in 4 wks time and refering her to paediatrics etc. But added 'But I know you are against bottles' I am NOT against bottles. What I was against is people trying to force me into bottle feeding my DD when I was/am trying to establish Breastfeeding on NICU.

In the end I was in tears - first time since leaving NICU - and just feel really deflated about the whole thing.

Since he left a few hours ago I've been having a real crisis of confidence and feel weepy and basically like I'm not doing enough for my DD

I'm in Ireland and even I have hung around MN long enough to know that HVs know nothing about bf!

I would ask him how many babies he has breastfed

Thanks everyone - I now have another prob and not sure where to post. DD has been fractious all evening and think this is because she is picking up on my mood. She has been sick a few times - which is normal for her.

However when I changed her nappy a few minutes ago noticed that her belly buttonis sticking out more than normal. Think this might have been because she was crying -loudly but also not sure if its a hernia....do you think I should be worried? Apparently DH noticed yesterday but failed to mention it to me

my first thought is wind but phone NHS direct if you are very worried, or see gp tomorrow?

Hi rascal, my dd has an umbilical hernia. Last oct(06) I noticed that her tummy button was sticking out really far. So did my mum and sister. I mentioned it to the Hv then the GP. They reffered her to the hospital. We've had a few appointments and if its not gone back by July she will have an opperation to correct it.

They described it as being like a holey pair of tights. When your toe pops out of the hole sometimes. Its only a problem if the 'toe' pops out and can't get back in. Crying makes it pop out more.

BUT the doc did say that 90% Iirc close up themselves in the first year, then another larger percentage do the next year. dd will only have opp if it doesn't go by itself.

I'd go to gp to let them check it out. They said its only a problem if it pops out and then gets stuck and doesn't go back in. they said it would be VERY painfull and I'd know if that happened as dd would be in a lot of pain.
HTH

I've got the 'chief HV' coming tomorrow! to do heel prick test so will have a word with her - she's actually really nice. I'm at GP on Thurs so will mention then too!

Great. I do think its very common in little babies. the doctor told me that they just haven't closed up in time before being born. Most do after a while. dd's just hasn't yet.

rascal what a pain in bot your hv is, my sympathies.

hernias; my ds had an inguinal (groin) hernia as did dh as a baby. that requires an op because it is more likely to strangulate (bits fall out of hole and get stuck). i don't know much about umbilical hernias, except that they are less likely to operate and it is more likely to correct itself as princess mel says. gravity and growth i should think.

anyway even if it comes to it the op isn't too bad, ds was fine the next day.

Hi pruners - have only just got back to this.

In my day (back when the earth was still cooling), the responsibility of the HV was the health and development of children up to the age of 5 years. This included general health and development, hearing, sight, speech and language development and immunization and all the screening that goes along with that. There was a fairly heavy emphasis on public health ( such as contact tracing in communicable diseases)and child protection. We were also pretty closely involved with fostering and adoption work. Health education and nutrition and general feeding advice/baby clinics were just one part of all that.

However, in those days, although the midwife had a statutory duty to visit all new mums and babies twice daily for the first 3 days and once daily until day ten, the midwife was "allowed" to continue visiting until six weeks after delivery if there were any problems needing her advice and support. This usually applied to breast feeding. The midwife was not supposed to "hand over" to the HV until she was satisfied that feeding was established.

So - to be fair to the overburdened HVs, I think the lack of support for breast feeding is more due to the shortage of midwives, lack of training of midwives, and the fact that new mums are lucky to see the midwife a couple of times postnatally. The six week extension of midwifery support has gone completely.

I still work in the NHS, and IMO one of the biggest problems is the delegation of tasks to people who are unqualified/untrained. It may save money in the short term, but it creates more problems in the longterm. But the NHS is run by accountants, not clinicians.

Message withdrawn

We got 12 weeks obstetric training. The rest was all developmental psychology,social policy,communicable diseases, public health, neurological development etc.

I forgot to say that we were also responsible for visiting the elderly and housebound and liaising with housing and social services. We were all attached to general practice, and dealt with anything else that was considered appropriate.

I used to do an "obesity and blood pressure clinic". We did know, even back then, that too much salt and fat was bad for you, too much junk food made you fat etc etc.

Just had a visit from my HV boss and I mentioned to her about yesterday. She agreed that his comments were wrong and reassured me that DD is thriving and we are both doing really well

Just took her to be weighed and she's put 4oz on so is now 4lb 11oz!

Big fat raspberry to my HV

Yay for little rascal !

Am joining you in raspberry blowing right now.

I was telling my Dad about the foremilk/hindmilk thing and people saying about lengths of time to get to it. He reminded me that the milk you get first from a goat is slightly less rich than that at the end - but that he can milk in a minute, and I take 4. Same amount of milk comes out at the same concentration (at milking competitions the protein and fat is measured). Makes sense - some babies feed faster than others, just as we sometimes stuff our food down, and other times linger, but the same amount of food goes in !

cmotdibbler, farming folk always give great bf advice! FIL used to always comment how the calves that got the "hot milk" straight from the cow always did better than the ones who were fed formula!

well done baby rascal, and well done to you for getting her there

I'm glad your confidence has had a boost today, keep up the good work

hooray for rascal and babyrascal! And boo to stupid HV. Like the comment about asking him how many babies HE has b/f.

cmotdibbler, great farming analogy (and fab name, too).

Rascal, so pleased your daughter is gaining and yah boo and sucks to your rotten HV.

Just wanted to sound one warning note. If your daughter has a weak suck or isn't sucking much (common w preemies) you might want to pump to make sure your supply is maintained. I've seen a couple of people's supply absolutely tank after a few weeks with a preemie because of lack of stimulation.

Apologies if you're already pumping, I just didn't see you mention it. You can freeze what you pump since you don't need to top her up.

hmmm I am pumping the left side cos she can't feed off this side atm. but not the right which she does feed off. No-one has mentioned to pump cos of weak suck and the nurses at nicu and bfc have seen her feed.

My breast feels softer after a feed and this is what they said to go off. I have a good letdown and supply seems fine.....

Also been pumping for 12 weeks now since she was born and never had a prob with supply.

Anyone else got any suggestions about this?

no advice rascal, sorry, but keeping this bumped for someone who does

i was also told the 20 min thing when bf my (slightly) prem twins in hospital and after being discharged was bullied by hv into ff once a day in grounds of slow weight gain. slowly i learned to ignore these people and bf my girls for a year. good luck and look to your counsellor and consultant for advice and ignore the rest.

the soft boob after a feed sounds like a really good sign. I guess if you were worried you could pump a litttle bit on that side after a feed?
bumping for you so more knowledgeable people can comment...