I think I’ve found the flaw in the local NHS provision. If you don’t like your doctor, you can change doctors relatively easily (I believe. I’ve not tried to change doctors since I came to Liverpool as a student, but I seem to recall that you find a new doctor who will take you, and give them the little green card that your mum kept with your birth certificate, and it’s done). Ours is a decent-sized practice, so it’s perfectly possible to avoid a doctor you don’t like without doing very much at all. However, there is only one HV, and she is attached to the practice, so how do I get rid of her without switching practices, and probably districts?
I didn’t like her when Daisy was a baby, either. Someone once asked me what was wrong with her, and I said, “Nothing. She’s a perfectly nice woman,” in venomous tones. It took me some time to work out exactly what I don’t like about her, and it’s this: she seems to be constantly on the look out for the thing you’re doing wrong. Whenever I see her, she seems to be working through a list of questions, desperately looking for the thing I’m doing wrong, so that she can tell me I’m doing it wrong. As a result, I try not to mention things I expect she’ll disapprove of (such as the hammock, for example), and thereby render her role a complete waste of time.
It’s not just her. I know people who like their Health Visitor, but I also know people who pretended to breast feed after they’d switched to formula, because they feared disapproval.
Can’t you just tell that I’m starving the poor child?
Having gained a pound a fortnight, more or less, from being a fortnight old, he has only put on ten ounces in the last four weeks (allegedly), and that flags some kind of health visitor alarm, apparently. I admit that, if it’s not a mistake in the measurement (possible, surely?), then it’s a significant drop-off in weight gain. However, he’s a big lad, it’s only just across the line she was concerned he’d crossed on the infernal chart, and I’m not worried. Well, I am, because she shattered my confidence and worked me into a complete state in twenty minutes flat, but I resent it, because she’s wrong, and he’s fine.
So then she starts with the questions – the I’ll-Keep-Going-Till-I-Find-Something questions. How often do you feed him? Do you feed on demand, or to a schedule? Do you always offer the second breast? How long does he go at night? Have you considered waking him for a night feed?
No, no, no, no, NO. Silly, silly woman. He is twelve weeks old: he is fed to a combination of demand-led and schedule-led feeding, because that’s what happens. You settle into a routine, you know when to expect him to be hungry, and if it doesn’t seem likely, you fob him off with something else. If nothing else works, you feed him anyway. If it’s been nearly three hours, you try feeding first as last. Breastfeeding is a dialogue, the process evolves. The feeding relationship that caused him to gain steadily for eight weeks has not suddenly broken down. If he’s not taking as much, he’s clearly not as hungry. Maybe you’ve got supply and demand all mixed up – sure, a baby won’t grow if you don’t feed it enough, but equally, it won’t eat as much if it’s not particularly engaged with growing. No, I don’t offer him the second breast, because it’s very rare that empties the first breast. If he’s unsettled when he comes off, I give it a squeeze. If milk comes out, I figure he’s stopped because he had enough. If it doesn’t, I put him on the other side. Again, no hard and fast rules – dialogue. No, I am not inclined to always put him on the other side because a) that would give him a burst of low-calorie foremilk, which wouldn’t do much to solve his weight gain problem, and b) I have one nipple that has never quite healed from that first week, and it really wouldn’t cope with being latched onto at every single feed. I don’t deprive him, I just don’t do it unless he insists. Dialogue. See?
Babywearing makes Daddies more
handsome, don’t you think?
She utterly shattered my confidence. I no longer believed that my milk was good enough for him, that I was doing it right, that I wasn’t selfishly starving him at every feed without even realising it, that he was quite capable of telling me when he was hungry, that I know my baby, and that we can communicate. I spent two days analysing and reanalysing everything about how I fed him, in case I was doing it wrong. And Kevin was furious with the Health Visitor for doing it to me.
He made a valid point, actually. Not only is my exclusively breastfed baby being measured on charts that even the HV admits are a farce, because of how they’re based on bottle-fed babies (and reading this article cheered me up on that score – his weight gain is actually supposed to drop off at this point!), but it was one anomalous reading. Any scientist will tell you that one anomalous reading does not make a trend, and certainly isn’t enough to change behaviour. Most scientists wouldn’t accept two, in reality, particularly in the case of a big lad like Henry, who has a fair amount of slack in his system, before it’s time to panic. How do we know that the scales aren’t playing up, that she didn’t read it wrong, that there wasn’t some other factor? Surely if I’d just fed him, he’d have been six ounces heavier, and she wouldn’t have raised an eyebrow? Note to self, make sure he’s just fed next time he’s weighed.
Henry has had the last word, though. It would appear that she caught him at the very brink of a growth spurt. Suddenly, two days later, he started waking in the night – twice, one night, which I don’t think he’s ever done before. He was avidly feeding, every 2 hours, every hour and a half, and less than that, sometimes. I wasn’t denying him, I was practising demand feeding, when he demanded it. I reckon he’s probably put on half a pound this week, he’s taken so much. And now, as suddenly as it started, he’s settled back down again – he’s boosted my milk production to where he needs it to be, and we’re all calm again. The dialogue is working fine. Leave us alone, you silly, silly woman.
To add insult to injury, the increased demand has made my never-quite-healed nipple especially sore again, so there was a point when I was wailing, “Why am I doing this to myself, when it’s not even working, and not even good enough?” The thing is, they say that they want to support and encourage exclusive breastfeeding, but they act like they want me to stop messing about and put him on a bottle, so they can control the situation properly. They’d never admit it, but a different mother would have done precisely that, this week. And then lied to the Health Visitor about it, for fear of disapproval.