Saturday, September 29, 2007

health visits

In the UK baby care is split between General Practitioners and nurses called Health Visitors (because they see healthy babies and they visit you in your home during the very early days). For any enquiries about whether something is wrong with your baby, you see a GP who may or may not refer you to a pediatrician. For weight checks and questions about growth and hitting milestones and weaning, you see the health visitor.

As far as feeding goes, the UK National Health Service takes the World Health Organization line of 6 months of exclusive breastfeeding, no solids til 6 months. So that's the advice given to average moms of average babies. That's in theory. In practice, things are different.

Cletus is breastfed, mostly. He gets one bottle of formula a day. It's largely for convenience. We did have to supplement early on because my milk was slow to come in and I was sick and exhausted. But we continued with the bottles because it's kind of nice for the Vol-in-Law to feed the baby and for me not to. Expressing hasn't worked out very well for me - so formula it is.

We also continued because of the number one advantage to bottle feeding: You can see exactly how much he's getting.

And that's reassuring when you have a baby who's a little bit of lightweight like Cletus. He's been gaining steadily, but he's in the 9th percentile for weight - that is about 90% of babies weigh more than he does. This past week he went up a bit to maybe 15th percentile - he'd gained 6 oz each week since his last weigh-in at the Health Visitor Clinic which was terrific.

So anyway, the HV said it was a good weight gain. But then she said I might want to give him another bottle of formula each day. She never once asked me about my breast feeding practice or my supply. I thought the NHS was supposed to be supporting breastfeeding!!?? How about having a chat about why I'm using formula to start with (convenience) and how I might ensure that Cletus is getting plenty of nice breastmilk rather than suggesting even more formula which would probably hurt my supply.

Then she said that he might want to start food soon, too to get his weight up. (He's not even four months old yet and is still sleeping through and doesn't seem ready for food) So I said, well maybe I'll start him on avocado or sweet potato when he seems more ready - as these are amongst the highest calorie weaning foods. She was adamant that I should start him on baby rice.Nothing against rice, but given his situation I don't want to fill him up on baby rice which has fewer calories than either breast milk or formula. So, then she said early weaning was not about quantity or quality but rather about getting them used to eating.

So why would I want to give my low-weight baby cereal which might see him getting fewer rather than more calories in a day? Well, I don't guess I would.

I think this advice is bad. I'm not arguing against flexibility. I'm not an adherent to the no solids til six months guideline. And clearly I'm not against mixed feeding, since I do it myself. But I think this advice goes against even the spirit of the feeding recommendations - more human milk for human babies for as long as possible.


furrow said...

As far as I can tell, nearly all babies end up eating solids before 6 months, but it's because they're pulling it out of their parents' hands. How odd that the "establishment" is trying to undermine breastfeeding. I can see that happening here, but I thought things were better abroad.

However, I LOVE the idea of home visits. I'm supposed to take my babe to the pediatrician within 48 hours of coming home. Hell. Will I even be able to contmplate dressing myself in 48 hrs? And I thought new mothers weren't supposed to drive so soon. Luckily, I'll have a driver, but certainly not every new mother does.

Vol Abroad said...

yeah the home visit is good

I don't know when we'll start feeding solids. I did just buy some cereal that's mostly quinoa, which has more protein

marsha said...

I breast feed all five of my children until they were two. Ok one of them was almost three but she wasn't giving up the boob without a fight. I also started feeding them real food about 3 months of age. I used to squish up what ever I had on my plate and put a dab on their little tongues. They all grew up just fine. Their favorites included mashpotatos and gravy, squished green beans and carrots. :) I think as parents we have to decide what is best for our babies. My way worked for me and your way will work for you.

Anonymous said...

Well said, Marsha. Go with your thinking. You are a bette thinker than most. VolMom

KathyF said...

There are as many opinions on feeding baby as there are people, I've learned. Don't sweat.

That said, I think rice is recommended because it's the least likely to cause allergy. Quinoa is high in protein, but proteins cause allergy. So maybe stick with rice. But not till later. Breast really is best.

My last one refused a bottle at all. I was trapped. Glad you have some relief from that, and Dad gets to participate.

BTW, do you remember the time Phil Donahue wore the fake breast shirt?