Why do HCPs come out with such rubbish about bf?

[alexpolismum]

This is a genuine question. I'm wondering if doctors and nurses, etc etc who work in paediatrics or neonatal care or in any way work with babies receive proper training on breastfeeding. Surely they must have to study something about it?

I gave birth on 28 Dec and my baby was in the ICU for 3 weeks. During this time I expressed for the new baby, while continuing to bf my 19 month old dd. During these 3 weeks, I was amazed at how many things were said to me about bf by the ICU staff.

• one doctor (a neonatal consultant) told me to stop bf my dd as it had been of poor quality and had no nutritional value since she was 6 months

• a nurse told me "if it doesn't hurt, it means he's not getting any"

• (nurse) "tandem feeding harms the new baby, it always means he doesn't get enough"

• (doctor) "colostrum is of little value, there's no point in expressing it"

• (nurse) "you musn't leave a baby on the breast for longer than 15 mins, it's bad for them"

• (neonatal doctor) "you must eat plenty of [long list of fruit/ veg etc] to make sure your milk is good quality and has all the right vitamins and so on"

I also overheard a nurse telling another mother with a three week old baby that she should give him a bottle as she (the mother) had to learn how to feed with a bottle in case bf didn't work out.

I don't get how they could really think these things (and there are more!). Surely they have to study bf, it is quite significant in neonatal care after all.

Shocking, isn't it!!

I am surprised you got to 19 months feeding your dd without having met a woefully ignorant health care professional before now!!

I hope your new baby didn't listen to them and is feeding well.

Because they are taught nothing about it.
Nada.
No training at all.
tis ridiculous

Please tell me that isn't a UNICEF Baby Friendly Hospital...

That's truly atrocious. If you can be bothered, complain.

Lordy.

It's true. I am a GP and have had diddly squat training on breastfeeding. I know lots about it now though having fed 2.

No, it's not a baby friendly hospital.

I have met ignorant health care professionals before, my dd's usual doctor told me to stop feeding her when she was about 10 months (we went in for routine vaccinations), but (naively) I expected more of the staff of a specialist neonatal intensive care unit.

ChewyToffeeMum - I'm surprised that GPs don't have SOME bf training, even one session!

Fortunately, once he said goodbye to the gastric feeding tubes and came out of the ICU, ds2 started feeding really well, so he didn't listen to them!

Off the cuff...

Dire lack of training

Personal agenda (didn't feed/didn't want to feed/product of 1950s pro-formula culture)

Did feed and found it easy so can't understand why others don't (not a dig, ChewyMum - am glad you are a bf friendly GP

Heavily targeted by formula manufacturers' educational material (this is a big problem)

Male and therefore uninterested in "wimmin's stuff" (though I know there are good male doctors who are willing to listen and learn

Anyone think of any others?

wuglet that is not true that they get no training
I am a lecturer in child health and our students get a full day on BF and they have to demonstrate in practice that they can give advice to mothers
the university I work at was the first ever to be given baby friendly status for the quality of its bf education
BUT
not all courses are like this and most neonantal units have a high proportion of adult trained rather than children's trained nurses in them and this means they get diddly squat input on bf

mind you, one of my personal favourites was the nurse who asked me if I had been adding cows milk to my EBM, as "you can't possibly be expressing those quantities"! (After the first few days of colostrum in tiny amounts, I started expressing loads, around 200mls from just one breast)

Not to mention the doctor who said "are you sure?" when I said I was still bf 19 mth old dd! What did he expect me to say? "Er, maybe I just imagined feeding her this morning and for the last 19 months!"

andiem - good to hear that there is some training out there! Is this a relatively new addition to the course, or has it been like this for some time?

it's been like it where I work for some time but saying that I have received some cr*p bf advice from hcp's and heard some so I am not all rosy about it

andiem do you teach medical students?
Because that is who I was meaning (although am sure nurses are bad too!)

I am allowed to say that because I am a GP
I had no training at all.

Became interested after doing it myself (and joining MN!) - have now done the 18 hr BFI training and just getting involved in development of university course aimed at precisely this group (paeds/GPs).

DS was admitted to our local paeds unit last week (fine now) and I was asked if he had been breastfed by the admitting Dr, a staff grade locum.

I said yes, he is still breastfeeding. She looked at me all puzzled, looked at the notes, and said 'STILL breastfeeding?'

'Erm, yes, still breastfeeding'
'Does he have solids as well?'
'Oh yes, he eats lots of food too'

Does he have solids?? He eats more than my nearly 3 yr old...he is 13.5months.

wuglet yes we are let loose on the medical students as well

moaningminnie - I had something very similar! When I mentioned that I was still feeding my dd (19 mths), one of the doctors gave me a strange look and said "Don't you realise she should be on solids by now?"

I found it very difficult to keep a straight face!

wuglet - although of course I think GPs should receive bf training, I think it's a lot worse that specialist neonatal consultants seem to know nothing about bf!

I take anti-depressants and had a very nasty run in with the senior consultant psychiatrist for the trust who was horrifiedto I was feeding 8 week old DD2 whilst on meds and then was absolutely disgusted find out I was bfing DD1 as well (23 m/o). I also got some tripe about not when they have teeth and definitely stopping by 6 months. The best bit was when he suggested it was me FORCING DD1 to nurse as I got my jollies from it.

I ended up having a breakdown and had to see the MH crisis team psychiatrist. I was explaining to the DR about the cons. saying I had to wean DD1 NOW and Dr very gently said 'well she does need to eat food at nearly two'. When I explained she had 3 meals and 3 snacks a day, he said to carry on and couldn't understand what the fuss was with feeding a toddler.

I've actually never had really bad advice from HCPs. I don't ask for advice (ever) but when DS was in hospital at 13mo, the nurses were quite pleased that I was still BF - I could see the stress for everyone involved when they were trying to convince babies and little toddlers to drink while ill, and making sure they got some food with their medicine. I remember one mum practically running down the corridoor, excitedly waving a bottle at a nursing saying: "he took x mls!!"

Even non paeds docs were happy - the ENT specialist (DS had an ear infection that went to the bone above his ear - could have gone to his brain!) was quite happy for me to BF while he did the exam as DS stayed still

The only dodgy comment I have got is since getting pregnant - one midwife (not my normal one) suggested that my supply dropping while pregnant was because it was 'natural' to stop between babies to make way for the next. I said I knew (well through mumsnet mostly) quite a few tandem feeders and had plenty of confidence in what we were doing and she shut up, although she did suggest her student do a study on tandem feeding for her dissertation!

Yep when I took 13 month old DS for his jabs the nurse went to fill in the form and said "Oh you're not still breastfeeding, are you?" as if it was a joke. When I said yes she said "Oh, well... um... exclusively?" (I think it was for the form as these were the 2 month jabs, I delayed them) I said "I think so. He doesn't have any other milk. He has food of course!" She genuinely didn't know what to put on the form.

Generally though HPs I have seen have been pretty good. Apart from the NN who weighed DS at 4 months, proclaimed that his weight gain was slowing too much and asked whether I had been tired or busy lately - I had, what new mum isn't? - And insinuated that this was affecting my milk and I should wean him onto baby rice.

Seems to be very much a postcode lottery. Mine was a baby friendly hospital with very good resources for breastfeeding counselling and a milk bank, so I never heard any of these interesting comments.

OP I would definitely complain about the consultant who advised that Colostrum was of little value and there is no point expressing it because:

1. It's medically unsound. We were advised (DS1 was a 30 weeker and spent 7 weeks on NICU) that colostrum and breastmilk were the key way to prevent necrotizing enterocolitis which affects some premature babies.

1. I know how soul destroying it is, laid up after a section, new baby corridors away on a ventilator, squeezing away, syringe in hand, to collect just millilitres of colostrum. Had it not been for the fantastic nurses on the NICU telling me how marvellous my efforts were (and meaning it) I might have lost faith that my efforts were worthwhile.

No NICU should be giving out such duff and unsupportive advice. They only have to hand out Bliss booklets if they can't be bothered to train their staff.

When doing my placement on special care I was advised not to bother discussing BF with one of the nurses as she believed it was pointless and formula was superior.

This is a hospital trying to get to Baby-friendly status.

I gave birth in a hospital which has applied for baby-friendly status - had great care from midwives, brilliant bf support. However I have spoken to others who have given birth in the same hospital and they seem to have been given mediocre-poor support. So I think it also depends who is on shift.

I'm less surprised that doctors and nurses are a bit clueless as they spend most of their time focussing on what's abnormal. I still can't get over how many midwives and
HVs aren't clued up, when they are supposed to know much more about what's normal / healthy.

Like Bertie says it depends which individual you see - and while I would like to think that individual professionals can all have their different opinions / experience / style etc, surely it should be based on some evidence (but that requires ongoing training and I guess is expensive).

I had a mc when ds was 13mo and still bf. The mw at the EPAU knew I was bf as I decided not to opt for medical management - it was a missed mc - because they couldn't assure me it was safe while bf. When I asked her about ttc again, she told me that I could go ahead whenever I'd "given up the bf".

Luckily I knew from mn that bf had not played any part in my mc, or I'd have felt even more at that point.

When ds was 6 weeks old he had to have an abdominal scan.
Took him for the appointment and the dr that was there asked how he was fed...tehn asked if need be could she give him a bottle to make sure his tummy was full
Erm that was a stupid suggestion for many reasons one being that to get a bottle the nurse was going to have to walk over to maernity on the other side of the hospital to get one while my perfectly functioning breasts were in the room with us and just no you are not giving him a bottle I can feed him if his stomach needs to be fuller.

at all that rubbish, I think my favourite being "if it doesn't hurt, it means he's not getting any". Really, really think you should complain for the sake of other mothers. If you have the energy to do more you could see if they have any patient / parent advisory body to take it up with.