Breast feeding and health visitors

[Fibilou]

There seems to be a recurrent theme of health visitors trying to force formula onto babies when they don't conform to their growth requirements and I wonder why this is. Considering that BFing is high on most maternity units' agendas and that it is really pushed pre birth I wonder why HVs seem so disinterested (going by the wholly scientific "I read it on Mumsnet" method) and keen to push formula.

For example my best friend recently had a son and couldn't manage to BF in hospital although there was a lot of pressure for her to do so. She wanted to but ended up leaving planning to FF as she had received no help in establishing BFing, just pressure. I thought maybe her HV might try and encourage her when she was relaxed at home and help her with her technique but she just said "don't worry, formula is fine" and that was the end of it.

Which makes me wonder what the point is in all the Baby Friendly hospital initiatives if health visitors are going to undermine the BFing campaign by trying to pressure mothers into giving topups almost as a matter of course. As most women will see more of their HV than the MWs at hospital, surely they should be the most knowledgable about BFing and able to offer help rather than just an automatic formula suggestion

Views ?

Never seen any of this personally: my HVs were all for supporting breastfeeding, that was the default position. And very into showing you how to latch on etc.

Because they are overworked and frankly don't have time? Here they have lots of child protection issues and have to spend their time with those families. So it's probably easier from their point of view to advise FF, then they won't have to bother with you. Although my HV was pro BF, she could only come round once a week (for a few weeks, I've never seen her since!). It was presumably easier for her to suggest top ups with formula, then she could safely assume my DD wasn't starving.

Hi Fiblou - as a HV I can say that most HVs have bugger all education when it comes to breastfeeding. That IS changing but it's a slow process. As a midwife I was already very proficient in supporting breastfeeding but some of my colleagues in training had never worked with breastfeeding mothers before. We had just 2 hours of theory in Uni and the rest was learned "on the job" so to speak which is fine if you worked with a HV who was experienced and supportive of breastfeeding but less good if they were of the "oh just give him a bottle of formula" ilk.
Where I work we have breastfeeding supporters called "Little Angels" who are fab - they see women antenatally, in hospital and visit at home too. They also provide a 24 hour support line as well. Most of the HV's I work with are mothers themselves and most breastfed their children (I am the exception due to ........ bugger all support from my HV).
One HV has just stopped BF her 2 year old and is absolutely brilliant at helping women who are struggling. She is also very pro extended breastfeeding.

Unfortunately this support doesn't happen in every area and with the decrease in HVs (and I appreciate some are crap at BF support) it's got harder - hence why the PCT in my area decided to invest in the Little Angels support. Whether the money will still be there in future remains to be seen but I hope so.

Also some HVs don't understand the charts in the red book which are growth charts for ff infants generally.If you DC looks like dropping down the charts, they will often suggest topups although the curves are different.

I had a HV with DD who belived every baby should follow the 50th centile and should either be fed up or food restricted to get them there.

Its the opposite around here. The hospital I had ds at couldn't push formula onto me quick enough the health visitors were more supportive of bf.

What area are you from JOllypirate, do most NHS trusts have these little angles to help with bf

Had one HV who had never heard of any breastfeeding clincs, advisors or helplines to help you bf, but found out 6 months later she wasn't a HV at all, just an unqualified assistant. Moral: just because someone weighs your baby and gives you advice and acts like a HV doesn't mean they know anything about anything.

Out of the two real HVs locally, one suggested I resort to formula when she was probably worried about me getting PND from bf pain and problems, and the other was great - encouraged me to feed ds resting on the table in her office and informed me she was tweaking the records so I was getting a home visit from her in a couple days. But most of the time you see the assistants who local GPs refer to as 'terrifying'!

I experienced this with my HV. All the wonderful midwifes who supported me were, without an exception, pro bf. Problem is I really struggled with bf after midwife discharge and my HV was just rubbish. She frequently insinuated the midwives bullied women into bf, and told me bf was only necessary for 6 weeks. DS lost a small percentage of body weight after birth (as to be expected, and under 10%) and she advised formula top ups. Maybe she was trying to make me feel better but I didn't want to be told ff was ok, I wanted practical help to resolve my problems. Was she overworked? Probably, I don't live in an affluent area. I still don't think that justifies her total indifference to my problems and that her answer to my tears of anguish of 'failing' was to give me a leaflet on safe bottle sterilisation. I haven't seen my HV since DS was 2 weeks old and I ended up devouring forums such as this to sort out bf. It's fine now, but it took until 16 weeks before I could say that.

Mine seems a bit meh about it (bf), not terribly encouraging.

My S lost >10% of his birth weight when my milk took aaaages to come in. Formula top ups were definitely mentioned at some point, can't remember if it was MW or HV suggestion. I didn't want to and he subsequently put on loads of weight anyway.

I said I was thinking of going to the local bf group, it had been cancelled due to lack of interest. I was a bit at this, she was very matter of fact about it "Oh well, it's a personal choice" was her only comment. Which of course it is, she could count all the people she has that bf on one hand though which seemed a bit sad.

I felt like the only bfer in the village, but have since discovered about 3 more and a mix feeder at baby group (out of about 17) so not totally the odd one out. ;)

I'm guessing my thread might have been one of the ones you mentioned at the top

Hospital were just as rubbish as the HV's to be honest. While I was there I was the only Mum on my ward that I didn't see with a formula bottle!! I asked to have my latch checked before I went home and had someone half-heartedly peer at me while I fed! I think, if I hadn't already had DS and known what I was doing, I'd have opted for formula too.

I did have 1 good midwife who was very pro-BF but even she almost made me feel like giving up because she decided that my latch was wrong and was trying to force me to latch DD on using the opposite hands which actually made it harder for me and caused DD to endlessly lose her latch!

My HVs were great, regularly staffed the breastfeeding cafes and always really supportive (and brought a BF counsellor to see me at home when DS wasn't putting on weight). In fact no-one suggested formula at all (well, no health care professionals) even though DS was crawling along weight charts - everyone was v pro breastfeeding, and not just with words, ifswim?

Hi piglet - I am in essex but Little Angels started in Lancashire I think - they are now in a few areas and are brilliant. Amazingly though some HVs view them with suspicion

... and I would echo what chocolaterabbit says about some HV's not understanding centile charts.

thanks jollypirate I am in MIlton Keynes, if another dc comes along i will enquire about bf support

It really varies from area to area and HV to HV. I help out in a baby clinic, and the HVs and assistants know that if a mum has BF issues, they should just pass her over to me. And I know at least one of the HVs has BFN helper training.

Breastfeeding support in our area is infinately better than eight years ago. Eight years ago breastfeeding support was truely dire.

Health visitors that I have met have all been trained in breastfeeding, although they could do with more training. What is good is that refer breastfeeding problems to someone more experienced.

The lack of health visitors is a big problem, not just for breastfeeding but detection/ treatment of postnatal depression.

It is really annoying when someone passes themselves off as health visitor and they aren't. There is zero point in me discussing mental health issues with someone who ain't qualified in that particular area.

Many nursery nurses are excellent for advice on childcare. I don't see what purpose having community nurses serve.

I'm in MK too piglet and even though my HV's are Pro-BF on the surface, Top-ups were mentioned at the first ever weigh in where DD dropped off her line