High BMI related appointment - can I refuse?

[coffeeforone]

So at my booking appointment last week my midwife weighed me and said “I’m not sure what your BMI will be - I’ll work it out if it’s over 30 i might need refer you to weight management/glucose test”, otherwise low risk, 2nd pregnancy, no issues last time (I was a bit lighter at booking in then BMI just under 30 so no referrals suggested last time)

So I received an appointment for a glucose test in 2nd trimester - absolutely fine with me!
I then received a letter for 2 extra growth scans in third trimester - also fine with me!
Then I received a letter for a hospital consultant appointment at 16 weeks. It clashes with my first midwife appointment so I may need to change it. Not exactly sure what it’s for, but I’m assuming to discuss risks re raised BMI?
In the same envelope there was another appointment letter for a ‘feeding clinic’ to discuss infant feeding - also with an additional ‘optional’ extra session on colostrum harvesting, attached to a leaflet about weight management.

I’m confused about why the final appointment re feeding is necessary and what it has to do with my BMI/pregnancy risk. I will be formula feeding from birth without doubt. Trying to BF my first almost broke me and I’m not putting myself through it again. I do know how to bottle feed as it was less than 2 years ago that DS was born. Do I still need to go along? I don’t want to look like I’m not taking appointments seriously but I’m not sure what use it would be for me and how my BMI makes any difference if I’m FF.

Also, should I be expecting any more weight related appointments or does the above cover everything? My BMI is about 33 BTW!

Aren't they just sending everything out in the same envelope?! Not necessarily linked.

Maybe the feeding clinic is nothing to do with your BMI and just something new your trust is offering?

The feeding clinic appointment was stapled to the weight management leaflet which talks about colostrum harvesting. I never had any of these appointments last time so I’m sure they are all BMI linked.

Could it be to do with obesity being linked with formula feeding?

www.who.int/elena/titles/bbc/breastfeeding_childhood_obesity/en/

I’ve just read a bit more - I think it might be if baby is bigger and needs extra feeds before supply can catch up. Higher BMI means risk of bigger baby, hence the growth scans.

Although DS1 was only 6lb even though I gained an awful lot of weight during 1st pregnancy - still hanging on to a bit now hence the issue!

Basically you have been placed under consultant care due to high BMI.

You can refuse, of course you can. the clinics I went to were a pain the the arse. Just remember that they only want to look after you.

My clinic was to see the consultant, dietician midwife and then anethstatist.

Every. single. time I had an additional growth scan.

I refused to see the anethstatist again after the first time and the midwife dietician also. I had asked all my questions the first time and my weight always maintains naturally during pregnancy.

@Isadora2007 so do you think it’s just to encourage breastfeeding? I’ve already decided on that point. DS2 was on 50th centile from about 3 months (he had trouble gaining weight initially because of BF problems), and is still on 50th now

@SkaPunkPrincess thanks that makes sense. Sounds like a pain though. I weighed more at this stage in last pregnancy and had no additional appointments! Just an earlier BMI check which was lower initially so didn’t trigger anything.

@coffeeforone The growth scans might not be due to high BMI, here you need a BMI of 35 to qualify on BMI grounds. However I'm getting them in this pregnancy because they do personalised growth charts and when measured against my height/weight ds comes in below 10 percent on my personalised growth chart so they are worried about growth restriction/placenta issues. Apparently the standard UK woman is short...

I would think the feeding clinic is because studies show that not only are larger women likely to formula feed but also wean early and so they want to push breastfeeding. If that's the case, you can definitely decline if you don't want to go. Might be worth checking exactly what it is first though.

There will be lots of different factors. Mainly down to statistics for people with a BMI over 3o.

As it was my second pregnancy with a BMI of 43 AND my first was 9lb 10oz I was put under consultant care. No one actually explained this though I don't think. I just received a letter to attend a Healthy living clinic and then the consultant actually explained when I was in with her.

It's based on your BMI at your booking in, they can't give you a reliable BMI once baby starts to become a factor in your weight.

Yes I was thinking it was to encourage you to breastfeed. To avoid the risk of obesity for your child. Totally okay to turn down the offer if you’ve made up your mind to bottlefeed from the off.
I hope you get some explanations though as it’s odd just sending leaflets and making appointments. Weird eh? All the best for the rest of your pregnancy.

Why are you reluctant to go? If professionals have decided on an appropriate course of care for you, why not just go with it? Tbh, you sound a bit defensive over being obese.

Why are you reluctant to go? If professionals have decided on an appropriate course of care for you, why not just go with it? Tbh, you sound a bit defensive over being obese

I didn’t mean to come across as defensive. I’m more than happy to go to the extra growth scans/consultant appointment and the glucose tolerance test. I understand statistical risk associated with BMI and I wouldn’t ever be reluctant to have a checkup that is recommended for the health of me or my baby.

it’s just the weight related infant feeding appointments I think would be a waste of time. I had a really bad experience with breastfeeding before, mentally and physically broke me, DS struggling to get birth weight etc. I just don’t want to go though it again so we have decided to formula feed.

Whilst obvisouly you can't be forced to go, I think it would be a bit daft not to. Clearly they want to avoid additional problems for your baby. The NHS is overrun, they're not going to be asking you to come in just for fun

Clearly they want to avoid additional problems for your baby.

How would attending the appointment avoid additional problems for my baby if I've already decided re feeding method?

Well, I’m going to bottle feed too. There’s a massive push for breastfeeding, though. I’ve been informed of the colostrum harvesting class but I’m not going to go but I do attend all other appointments nonetheless.

Exactly, I think they should maybe have asked me before making the feeding appointment (especially as the NHS is so overrun), as it isn't directly related to high BMI pregnancy risk IYSWIM

I'll give them a ring and let them know I'd prefer not to go if its optional.

If you're certain you won't breastfeed then the infant feeding appointments will be a waste of time.
You'd be silly to avoid the medical appointments (which I don't think you are) but I wouldn't go to the feeding ones in your position.

JoJosm2 why not do just the colostrum harvesting?

Women with high BMI are statistically less likely to breast feed and those who do start are less likely to be successful so I can understand why your trust has decided to promote classes to try to combat this discrepancy. If you are already decided then just don’t go

I also got the feeding leaflets and colostrum harvesting leaflets attached to consultant appts.. and I have a normal BMI.
Just go to the consultant appt and ignore the other ones.

Lizard ..easy..because she doesn't want to!