HELP Health Visitor will call SS if I don't agree to weekly weighing and/or formula top ups

[curiositykilledhaskittens]

I have been breastfeeding my twins exclusively for 11 weeks. We have had a rocky start and a lot of interference which has varied from helpful to very unhelpful. The smaller twin did not regain birthweight for 3 weeks but has followed a line since regaining birthweight. The bigger twin has struggled to maintain a regular normal growth pattern and has dropped from the 9th at the lowest point after birth (1 week) dropped a bit more through the lines to inbetween the 0.4th and the 2nd and has been following a line since 8 weeks. The doctor and the health visitor have decided both twins are failing to thrive and need top ups and weekly weighing. If I don't allow them to weigh them weekly they will call SS, if they do not gain at least 4 oz every week and I refuse to supplement then they will call SS. Have spoken to BfN helpline and am waiting for NCT to call me back. Just don't know what to do. BfN counsellor says to stick to my guns and GP has little BF training but hard to do when you are being threatened with SS. Feel like running away though never would.... Just so sad and scared.

I think I would ask for a paed opinion anyway.

Also it might be worthwhile speaking to someone higher than the H.V and relaying your concerns that she is effectively 'bullying' you - frankly I think the HV is old school and is using these tactics to make you do whats easiest for her.

Im not a bf counsellor or advisor in any way but would it be so bad to top up?

are they still being sick because afaik reflux can be a cause of failure to thrive.

If the reflux is not controlled then a trip to the paed is in order. Asap.

Agree with others really, failure to thrive merits a paed appointment.

Stressful as it is at this point - you can complain about your gp and if you are not getting a referral to the hospital then I would also contact pals

I feel like it would be the end of the world to top up. I know it is slightly irrational. I'm worried it will interfere with the benfits of breastfeeding. I feel like it is just so hard and relentless BF twins that supplementing at all would just invalidate all that work. That I would be a failure. That they might prefer the formula and give up breastfeeding, that I might give them a bottle and it might only make them miss feeds and not gain anymore weight, that it might make the reflux actually become a problem (it isn't now). Seriously, I would definitely positively top them up if I felt they needed it but they seem fine to me. They are now (weren't in the beginning when gain not regular) pooing 2-5 times per day despite gaviscon bunging them up, loads of wees, they're hitting milestones ahead of time, they are smiley and happy and laughing and cooing. The ONLY thing is that weight gain hasn't been perfect. Doc even agrees with that statement.

Curiosity stick with your instinct then .

What everyone is saying: insist on a referral either to a paediatrician or to a hospital breastfeeding consultant.

I wouldn't just stick to my guns in the shape of doing nothing at all: I did that with my own dd, and- let's say it wasn't the right decision . Refusing to have them weighed could be risky if there is a problem- unless you are weighing them yourself and keeping a careful eye.

But otoh you don't want to be bullied into formula until you know what the real problem is.

Not sure falling 2 percentiles automatically means a failure to thrive, and think it's more of a long term issue, so not sure how it could be diagnosed at 11 weeks .

DS was FTT at 13 months, but it was a dairy intolerance that was the root cause, and am fairly sure that a FTT means failing to achieve milestones on repeated basis, such as weight and height over a span of time.

If it was me, I'd ask for a Paed referral and call SS myself and discuss rather than being threatened.

How dreadful for you.

Are they using bfeeding charts or bottlefeeding charts?
They had a good go at pressuring me to bottlefeed my prem as they told me he wasn't gaining enough. (he wasn't even on the line for along time}
It was only after getting support from the breastfeeding cafe that I felt I could stand up to them.
They also had different charts to the ones the hv had.

I ended up just giving him one bottle at night and quickly got used to it so don't feel bad if that's what you do in the end.
I was so sore that it was a bit of relief to give him a bottle for that one feed.

Good for you for standing up to them.

I suggest that you find an nhs breastfeeding cafe where you can get the opinon of a different health visitor. Prehaps a health visitor who is more sympathetic to breastfeeding.

In our area you can go to any weighing clinic you like. For example I do not go to our local clinic because it is in a large and crowded room. I am scared of crowds and get panic attacks. Therefore I go to a smaller clinic about a mile away.

Could you get your twins weighed at a different clinic? If that is not possible would you consider changing GP surgery?

They are using the bottlefeeding charts. Not sure it would help to be on the breastfeeding ones as they should really be still gaining quicker than FF at this stage.

Some really helpful suggestions. Think I will ask for paed referral and speak to SS myself. Will look into a breastfeeding cafe. The HV comes to the house to weigh the babies which is another reason I want further apart weighings as it's very invasive coming every week. Not sure if they would take me changing GPs as a sign of it being necessary for SS involvement so that might not be a great idea. Might be worth getting my mum to speak to the HV. She thinks 2 weekly weigh ins and weaning from 17 weeks (which is what I would prefer over formula top ups) would be a good plan and has seen all their charts/watched me feed/has lots of experience BF 4 children herself/is pro BF....

I understood that bfed babies gained alot slower than ff?
SO you really should be using the bf charts not ff as you are bfeeding - that makes sense to me!

Oh Boo, baby cafe too far away!

Hi curiosity

As a HV myself I think your HVs threat sounds hideous and not at all supportive - feel quite angry for you - and I know I don't see your babies and have not seen their charts. From what you say in your OP it sounds as though they are following a growth line - albeit not the one they were born on (and many babies don't follow the centiler line they are on at birth). The weights should ideally be plotted on a breastfeeding chart and not the older ones. If they are both following a growth line I doin't actually see the problem but then am not your HV.

As you've said above - ask for a referral to a paed and don't be fobbed off. Tell the HV that you will go to a clinic. You are not compelled to let her in to your home - just say it's not convenient.

Hope all goes well for you.

curiosity - DO call Mars - she is wonderful.

And I agree, ask for an urgent referral to a paed.

I think the gp and hv are nervous, as someone else said, and they don't really believe you can bf twins.

It's me, ZM by the way. DT2 now 18 weeks and still following a line below 0.4th centile - born 5.6 - was this heavier than your 2? he's only 10lbs8 at 4 months but hitting all milestones etc and HV delighted with him - she has lots of bf twins experience.
Hope you can get this sorted soon.

The bottle feeding charts are not appropriate for bfed babies at all. FF babies gain weight faster and more predictably than bfed babies. They should use the BF charts. If they don't normally use these, it says a lot about their attitude. I suspect a paediatrician would be very surprised they are not using BF charts.

They sound just completely ignorant about breastfeeding, and unsupportive, and the stress they have introduced into the situation can't be helping either.

The babies are following a line, the nappies sound ok.

If you find there's a time, late in the afternoon, for instance, when you don't seem to have as much milk yourself (this is sometimes the case in the late afternoon), you could try topping up after bfing them with a little formula? But only after seeing a paed. FWIW, I topped up my 5th because she was in danger of jaundice after drastic weight loss after birth, felt I was a failure and doing her more harm than good, but when she got more into the whole feeding thing, we returned to exclusive bfing and she kept at it for almost four years. You do feel terrible to resort to the bottle though. xxxx

math, sorry, this is incorrect info - ff babies don't gain faster than bf babies at this stage. It's the other way about until about 5-6 mths (though the diff is very slight).

Bf babies gain very slightly more quickly than 66 for the first few months.

The paed won't surprised if they are not using the newer charts - not everywhere has bought them yet, but as I say, the real diff. is not seen until about 5-6 mths when ff babies gradually start to gain faster (the diff is very marked by a year).

This is outrageous threatening behaviour from your GP and HV assuming that there are no other issues apart from weight gain.

Insist upon a paediatric referral before any other course of action is agreed upon, if your GP refers you urgently then it is likely that the babies could be seen in 1-2 weeks.

DT2 exactly the same as yours. Was also born 5.6 but term... gah... NCT called back with address of nursing matters advocacy so going to try that and requesting paeds referral to breastfeeding specialist.

True, Tiktok time with little babies turned my brain to mush I fear. I'm very surprised to learn the HV here only has one set of charts, the FF one even moreso to think the paed might not think this was odd. Even 20 years ago my doctor had BF charts for oldest DD's weigh-ins.

There is some good advice here - I think asking for a referral to a paed is a great idea, as it shows you are willing to work with the HCPs (albeit different ones to the current bullying ones!)

As you know curiosity I BF twins exclusively and they were always right at the bottom of the chart (didn't start there tho). But as long as they always gained weight (even if it was just a little) I was happy. If your DTs are gaining weight and following a line then I can't see how they can diagnose FTT.

I totally understand your reluctance to introduce formula. You are still building up your supply and ff would interfere with that. Your instinct tells you they don't need top-ups and at this stage they don't.

The HV and doc are just protecting themselves by threatening to involve SS.

A more brazen approach?

My dh, who is a (very baby friendly - I made him that way!!) GP says that if your GP threatens SS again then you should suggest that in that case you refer the GP to the GMC for ignoring best practice for infant feeding.

HV can also be referred to the local Health Board (Scotland - not sure what it is called in England) once again for ignoring Baby Friendly practice - as most areas are despreate to be "Baby Friendly" this might help.

The twins need to have a load more symptoms to be diagnosed FTT, this is ridiculous. You shouldn't need to see a paed, but if it keeps them all off your back, worth the bother.

Good luck!

hello, I just want to say that you are obviously doing brilliantly to be breastfeeding your little twins to this stage. the behaviour from your hv and gp sounds ridiculous...

my own experience of the health care profession so far (and I am a health care professional!) has been appalling in that they push formula first and foremost with babies who are slow to gain weight. My little girl is on the 0.04 centile and is doing great but they are still keen to see her on formula just so that she gets bigger more quickly. It takes a lot of guts to go against medical advice but you will choose the right path for you and your babies.

good luck.

math - new charts were introduced last year. The data is based solely on bf babies. Not all areas have got round to purchasing them yet - though most have.

There have been a number of 'bf baby' charts knocking around over the years, but the one I am referring to is the only nationally supported one that I am aware of.

The previous charts in universal use in the UK were called 'UK 90' and they were not 'formula fed baby' charts but based on data sets of babies whose feeding was not differentiated. Many of these babies were ff, of course, especially later on.

Curio

Talk to Mars, she is magic. You have loads of good advice here too.

A pead is what you need really. So sorry chick. How awful to scare you like this.