Is it possible to switch health visitors?

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.

Henry at 13 weeks - small
Can’t you just tell that I’m starving the poor child?
My own HV upset me this week, and I’m kicking myself for getting into the situation in the first place. I took Henry in for his second set of jabs (he seems to be getting more needles stuck into him than Daisy did), and she said “Would you like him weighed?” I should have said no. He was fine. He was alert, a good colour, weeing and pooing properly, sporting a non-indented fontanelle (which is how they check for dehydration in babies), and growing out of his clothes. I had no concerns, merely casual interest, and I should have resisted.

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?

Henry and Daddy at Thurstaston Beach
Babywearing makes Daddies more
handsome, don’t you think?
Then she said, ten hours is too long for him to sleep at night, and maybe I should wake him up at my bed time for an extra feed. This is not a baby who doesn’t tell me when he’s hungry. If he’s hungry, he wakes up by himself, and cries about it. If he can’t make the usual 9-10 hours, he wakes up early, and I have to feed him at 5.30, or something. The thing is, there are a handful of options when it comes to babies. One way or another, you have to get a baby from sleeping in 4-6 hour stretches at birth, to sleeping 11-12 hour stretches as older babies/toddlers. I’m mean, you don’t have to, but if you’re committed to unbroken nights, you do. To do this, you can either put your baby to bed at 7pm, wake them at 11pm for a feed, and hope that they make it through from there to 6am or so – I think it’s the Gina Ford/Baby Whispered preferred option, and therefore fairly widely used. It seems daft to me. How do you know when they no longer need that late feed? You could go on indefinitely waking them up from sleep that they need, to give them food that they don’t. It always seemed more intuitive, to me, to monitor how long they can sleep at night, and put them down that number of hours from when I want them to get up again. That is, every time he sleeps past 7am three nights in a row, I bring his bedtime forward by half an hour. That means that he’s in control of the process – he sleeps for as big a block as he wants/needs to, and I just tweak it to make the timing fit into when I want to be asleep. That’s how I’ve got to this point – he’s in bed by 9pm, and wakes up at about 6.30am. Not only is she suggesting what amounts to a step backwards, but it’s a step backwards to a place that I chose not to go to in the first place.

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.

4 thoughts on “Is it possible to switch health visitors?

  1. Ruth has missed a bit out (unbelievably?). We’ve done this before. Yes every baby is different and Henry is definitely different than Daisy, but we have managed the whole breast feeding thing before. And saying things like “he’s not teething” when he’s doing all the exact same things and the exact same time as Daisy is, doesn’t help.

    Also this is what happened with Daisy. We’ve looked the chart dipped at the same point, and Ruth got grief at the same point. It wasn’t as bad because Daisy didn’t dip below the line, she fell in the same proportion, but it didn’t cross the line.

    I’m glad Ruth blogged this because she needed to say it, and I needed to get it off my chest. Just don’t get me started on the breastfeeding propaganda and the pressure it puts on mums.

  2. Sounds like an insecure Health Visitor to me, unwilling to make allowances for variation in case SHE gets it wrong…

    Love Dad. xx

  3. Not to mention the HV who rushed my friend Sarah back into hospital because her baby was not gaining weight…her scales were faulty?!!!

  4. I’m glad that you are sticking to your guns. If you were a first time mother and got this news you would have thought yourself a bad Mum. Keep up the good work. It sounds like you have a sound head on your shoulders.

Comments are closed.