Not happy with out of hours GP, thinks he's a breastfeeding expert I think!

[TinkerbellesMum]

Just took Tink to the out of hours doctor because she is hoarse, hot, bad mood etc. I said that not only has she not had a drink today (thrown flask at me for offering) or eaten much (got angry I dared to go to the kitchen) she hasn't even asked for milk which she normally would if she's off everything else.

Doctor gives me a (smug?) smile and says "She's getting a bit old though"!!!!

Erm... by who's standards (or should that be WHO's standards?)? How rude, if he had been my GP he would have gotten far more of a mouthful, especially considering I'm just completing my training to work for his PCT in the breastfeeding department! It worries me I could have been someone else that wouldn't have been so up on "extended" nursing.

Think I will be speaking to my HV who's coming over this week and used to work for my dept and my practice manager who employs the out of hours doctor to see me.

(BTW, she has a slight ear and throat infection, not given AB's Calpol and fluids - and Nanny is looking after her tomorrow, having her over night and all day Thursday so she can deal with the moods!)

I would have asked him what evidence he based that comment on
I would also have asked him why he recommended calpol when ibuprofen is better as well just to really irritate him

why is brufen better?

Hope Tink is better soon, how did GP know you were breastfeeding her? how old is she?
do PCTs have breastfeeding departments?

sorry that sounds a bit cranky and it's not supposed to. I just had this image of the breastfeeding dept at the PCT pop into my head!
bit surprised the after hours commented TBH

it is better because it lowers the temperature more and the effect lasts longer it takes approx 10 mins longer than paracetamol to work

if she's only got a 'slight infection', wouldn't you 'prefer' the 'side effects' of calpol to brufen though?
I'm guessing calpol is cheaper too
(maybe he thinks 'look after the NHS pennies and the NHS pounds will look after themselves?!!)

I would have asked him what evidence he based that comment on

If I hadn't had to get her paternal grandad out to take me - my parents are away, TD is on secondment in Croydon - I would have stayed and debated the benefits of natural term nursing with him!

I would also have asked him why he recommended calpol when ibuprofen is better as well just to really irritate him

It's always puzzled me that they say "Calpol" rather than "liquid/children's paracetamol" you'd think they were sponsored (American stylee) by the brand!

Hope Tink is better soon, how did GP know you were breastfeeding her?

I said it had worried me because normally if she drops liquids and solids she asks for the breast more.

how old is she?

21 months, within the minimum recommendation

do PCTs have breastfeeding departments?

Ours do - Heart of Birmingham - there are others locally and I know someone somewhere in London, can't comment on others. They train local HCPs in breastfeeding (will be recommending he goes to see them!) and have a team of women (mostly mothers) who visit new mums at home to help out with establishing their breastfeeding relationship.

He's not given me a script, so no pennies to worry about

lol at the after hours going to see the breastfeeding department, you can just picture hi quaking in his shoes with sweaty palms as he knocks on the door!

Agree with the calpol, not sure I've even seen calpol written down on a bottle is that what you get when you buy it over the counter?

21 months is hardly that old is it?

(?HCP= health care practioner what kind of background do they have?)

think the PCTs around here are some way off getting this organised!

Do you visit on demand? Up to what age? Are there enough of you to go round?
(sorry this sounds like 20 questions really interested)

not sure what side effects you mean ibuprofen on the whole is safer than paracetamol

lol at the after hours going to see the breastfeeding department, you can just picture hi quaking in his shoes with sweaty palms as he knocks on the door!

hehe I'll set my trainer/boss on him!

Agree with the calpol, not sure I've even seen calpol written down on a bottle is that what you get when you buy it over the counter?

It's a brand name, you can get it as Calpol or as something else in a number of generic names.

21 months is hardly that old is it?

Nope and it's still within the recommended minimum age of nursing. It's no where near how old they have the ability to go for.

(?HCP= health care practioner what kind of background do they have?)

Yes, it's generic for doctors/ nurses/ midwives/ HVs etc.

think the PCTs around here are some way off getting this organised!

It's got to happen eventually, they need hospitals working to UNICEF standard soon and it's the best way to get it happening.

Do you visit on demand?

Either HCP or self referal, they just have to ring up and request a visit.

Up to what age?

From the start until they move to something else.

Are there enough of you to go round?

No. Some people are doing over 30 hours a week and it's not enough, we cover a large area and there's about 12 working it. They've constantly got a course running to train up new supporters.

(sorry this sounds like 20 questions really interested)

No problem

If I say children's paracetamol or ibuprofen to most of my patients I get a blank look until I qualify it with 'Calpol' or 'children's Neurofen/Calprofen', so its quicker to go straight for something people understand in the first place.

Ah, that makes sense. Growing up we only had Calpol, so I don't know if it's only recently that there has been more of a variety.

Need some help writing a complaint. Can anyone offer me some links with details about benefits of natural term nursing, official recommendations etc? Also suggestions of what you would politely say (OK, make me laugh with what you would want to say too!)

Thanks.

ibuprofen NOT a good idea on an empty stomach (DS always vomits it straight back up unless he's had a meal beforehand)

also not a good idea if you have asthma or allergies

effie perine there has recently been a review about ibuprofen and asthma and the link was disproved

here

I have a history of asthma and am unable to take ibuprofen and aspirin as it has made me wheezy in the past.

Hi TBM, just a quick note as I am having a (brief) breather from a marathon cluster feeding session, that is set to go on and on. There was an article in the BMJ a few weeks ago about breastfeeding that summarised all the evidence about breastfeeding and reiterated that the WHO's guidelines of breastfeeding to at least two years apply in the developed world as well as elsewhere. Might be worth citing in your complaint? Considering it's the most widely read medical journal in the UK - he really had no excuse to be so poorly informed! (I really despair of my colleagues sometimes.)

I would complain that me made an unecesssary, judgemental comment that contradicts clear, established medical evidence, citing the WHO guidelines. Attaching or referencing the BMJ article would be a good idea. And I would suggest that he contact the PCT b/f department to update his professional knowledge.

Dickhead.

he, even!

Thanks for that Lyra. Is it this one? That was April so I might see if I have any friends of friends who could get me a copy of it.

Edam, I will be asking my boss/trainer to find out who it was and suggest he gets the training!

My HV said it might not make much difference, but if it stops him from coming out with comments like that again then that would be good. (She said "well, you know, he is a man!") I think if I can send them loads of print outs/ copies of BMJ etc I can scare them into thinking I'm serious and maybe taking me seriously. I don't want to come off as just another hippy mum.

andien I'd have to read them, subanalyses are less reliable, did they exclude children with known asthma allready?, not sure what 'brufen being assoc with lower RR for hospn and outpatients for asthma' really means.

I was thinking about asthma, stomach ulcers, vomiting, renal failure and fluid retention
But we are off topic

I don't have much advice I'm afraid, except keep thinking about eh link on ?yahoo about breastfeeding making you brainier and the way it decreases the mothers risk of other conditions
Maybe tiktok or kellymom have some ideas?

More importantly how is Tink?

She's a lot better now, had a great time out with her grandparents. I woke up feeling totally rotten this morning, though, and am now on ABs

I need to be careful what I give to support me because if I say about general benefits, they could say "Yes, but you've got that done" not that I think they would be rude enough but I want to make sure my arguement sticks to "extended" breastfeeding.

Just to add to the mix, a HV at my clinic this week:

'you're still bf?' (Babychoc isn't quite six months: 'yes')
'no solids?''no'
'she should be starting now or she'll be behind' (eye roll)
'when will you stop feeding her yourself?'
(what a fatuous question this is)
'not sure, but not yet, as she doesnt take a bottle anyway'
'oh I see this problem all the time with mums who don't give a bottle regularly, you should express every day and then give it at night so they sleep better'
(whatever)
'anyway of course you can carry on feeding her yourself until she's one'
thanks, HV, for setting a deadline for me

Honestly, do some of these people know ANYTHING?

Sorry you're sick, Tinkerbellesmum, and get well soon!

'She should be starting now or she'll be behind!!!!!!!!!!!!!

Grrrrrrrr

These people make my blood boil!