If you are breastfeeding and attend a baby clinic

[JollyPirate]

Following on from another thread I feel this thread is necessary as there seems to be an awful lot of poor information being passed on by some HVs out there. I am not ant-HV - am a HV myself but I do get depressed when I see some of the poor advice given by HVs (and then posted here) with regard to breastfeeding and centile charts.

It is worth all BF Mums knowing that until 2006 growth charts were based on children with mixed feeding patterns, predominantly bottle fed (and these are the charts still being used in many child health records), but evidence from various studies shows that exclusively breastfed infants gain weight differently.

The concern with this is that misinterpretation of growth charts could lead to breastfed babies being given unnecessary supplements of formula. There is plenty of anecdotal evidence that this is happening - the last thread I read was from just ONE Mum being given erroneous advice - multiply that by the number of Mums her HV sees and then multiply again for all the HVs giving out such poor advice throughout the UK - no wonder our breastfeeding rates are so poor.

This is why WHO have developed new charts, which the Department of Health has recently recommended be used for all children from 2 weeks to 2 years. These should be launched by early 2009.

In the meantime - ask questions if you are breastfeeding and the HV suggests you wean early because your baby isn't growing well or because she thinks your milk is not necessarily meeting the needs. Your milk contains far more calories that a little bit of pureed mush - which might reduce the amount of calorific milk a baby takes.

Hope this is helpful to some of you.

And conversely, if your baby is gaining well or high up the centile charts, this doesn't mean you need to wean early either. In fact you can tangibly see how effective your breastmilk is.

Nice and clear. Sure lots of people will find it helpful. And it's a point that needs to be made.

Thanks JollyP I was suprised at the number of ladies at my baby massage class who had weaned really early at HV advice. She was saying the WHO advice of 6months is only so high because of the risks of gastroeneritis with making up formula. I know this is part of the reasoning behind the 6month recommendation, but not the only reason.

So thank you for posting, it's good to hear a voice of reassurance! x

Bumping this for the evening crowd.

No hanaflower - just ask the HV to explain why if they suggest early weaning - some of the charts do say breast from birth and that's an improvement but the new charts should make everything clearer for everybody.

Some of the growth charts are based on breastfed babies but I have not ever seen these to compare - I think they are better.

Interesting post My DD2 is a big baby - 90th centile height and weight and totally BF. HV couldn't believe it and told me to start solids as my milk would have enough nutrients- I ignored her and didn't go back! But i've noticed the Surestart centres/playgroups are giving out advice on early weaning and these people aren't even HVs

My chart doesn't say breast from birth on it. But when I took DS for his 6 week check up at 10 weeks (long story) the doctor asked me how old he was, I said 9 weeks I think, she didn't check and marked his weight down.

The next time I got him weighed they mentioned he'd fallen off "his" curve and did I want to speak to a HV (first clinic of the year and was being weighed by a helper), I said no, downloaded the breastfed charts from kellymom and by using dates rather than number of weeks realised not only was he bang on track using that chart, the doctor had marked his weight on the wrong week - he was fine and had barely dropped at all.

Also a few of my NCT friends had their confidence knocked due to this and both are now topping up, probably unecessarily.

DS had 8 wk check yesterday and HV said she would be sending an invite out soon re: a weaning talk, and made a point of saying that even though DS was bf 'the advice now is to wait till nearer 6 mths to wean him if I can wait that long (she made eye rolling motion)' I had to point out that the 'advice' is to wait to 6 months and that I didn't see why me bf meant DS would need to wean early (and yes he is a big boy which just proves to me what a fantastic job my norks are doing)

FWIW DS was only weighed as it was his check up. he is growing before my eyes and I personally cannot stand the importance that is given to centiles and charts. I realise that its important to monitor your baby's progress but some perople really do get hung up on what centile the baby is on.

Gosh daisy that's maddening. My dd was 26lb and nearly 7 months before she had any solids whatsoever. All my lovely hv ever did was say well done and give me biscuits. Why can't they see that your milk is clearly doing a good job when you have a healthy, bouncing baby in front of you. Heavens preserve us.

And Starlight, I just choked on my chocolate in . I hope you told them to beggar orf.

laughing at the idea of a dietician solemnly advising Starlight's baby of the risks of obesity if he carries on "overeating".
what nonsense.
I'm sure the baby would give an appropriate response to the advice. Maybe a loud, satisfied burp?

I think a fart would be more appropriate

Thank you so much to the OP for posting this.

hana the weight chart based on breastfeeding is to used for all babies because it gives guidance is babies physiologically put on weight. ie, formula is an alternative feeding method so it impacts the way a baby will put on weight.

For example, around 3 months, breastfed babies start to gain weight more slowly than formula fed babies who, otoh, start to put on weight faster than in their first 3 months. This makes it look like some breastfed babies are 'falling down' the percentiles, hence pressure are put on breastfeeding mothers to wean early or give formula top ups when their babies are doing perfectly well on breast milk.

Heard 2 mums sat discussing weaning and one said to the other she started baby rice on the advice of HV at 12 weeks! Apparently it was because she was guzzling several 8ox bottles

Sorry ended that post too early

This was last Friday. Just goes to show it isn't just bfing mums getting stupid out of date weaning advice...

Some HVs probably do give give rubbish advice, but not all, and maybe mothers use it as an excuse because they just want to start early. Easy to say the HV told them, no one can prove otherwise, HV not able to defend herself due to patient confidentiality. I'm a HV and never advise weaning earlier than 6 months. I explain reasons behind the guidelines, give out DOH weaning leaflet, lend Baby Led Weaning DVD and book etc. Sometimes the mum decides to give food early anyway. Her choice of course, but what really pisses me off is when it gets back to me (via via GP in one case when 3 month-old baby had been so stuffed full of rusk that he was being sick) that she was telling people I had told her to start food early because he was a hungry baby. I'm the only HV in town and I told her NOT to start, even wrote it in the parent held record. Of course she was probably feeling guilty but not fair to bame the HV.

Ah yes Stripeysox - that happens too as I am only too well aware and irritates me beyond belief as well. Some folks will wean when they want to no matter what the advice.
In my OP I was just shocked about the number of posts starting "... am breastfeeding and have been advised by the HV to wean my 16, 18, 20+ week baby because...." followed by some very dubious reasoning/advice.
It is crap when someone weans (their decision) and then defends themselves by telling people very untruthfully that "my HV told me I could".

starlight, those HVs who worry about speech development being affected by later weaning are completely missing the point. As I'm sure you're aware (but they obviously aren't) there's no need for purees if you start at 6 months, mashed or finger food is fine. So 6 month weaned babies get plenty of opportunity to exercise for their chewing/talking muscles. I've noticed that those who start on purees at 4 months tend to stay stuck at the puree stage well past 6 months, also their milk intake often drops because they fill up on easily swallowed purees. When offered food that needs chewing they get frustrated because they're hungry and mum goes back to spooning in mush.

Hurrah! There are two MN HVS - and we are on the same wavelength. Good to meet you Stripeysox.

Pleased to meet you Jolly . (Off topic but nice to see campaign for more HVs in Sunday Express today)

oh, god, not that 'it will affect their speech' rubbish! and speech targets! wtf!

i take it some people underestimate the power of sppeakin and reading to your children.