"Nutritionist" giving bad advice - Mothering Forums

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#1 of 8 Old 11-22-2015, 06:16 PM - Thread Starter
 
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"Nutritionist" giving bad advice

So, I had my premie evaluated when he was an actual age of 10 months, adjusted to 8 months of age. The evaluation was done by the county to see if he qualifies for free state services. (Luckily, he doesn't. He's developing great and was at about the 10 month level. )

What bothered me was the "nutritionist" and her evaluation. She gave me a whole lecture on weaning and how I need to wean my baby and I should avoid "nipple misuse" and breast feeding should only be used for nutrition. She said, "it's time to move on from breast feeding" and you don't want the baby "getting stuck on the breast" and you want to avoid prolonged breast feeding as a poor nutritional habit. Additionally, using he breast as a pacifier is nipple misuse.

The whole writeup she gave me is horrible and it's clearly discouraging breastfeeding. (And, you don't want to hear about the advice to Ferberize my baby to get him to sleep through the night. I told her we weren't interested.) Also, the recommended "daily menu" she gave me for a 6-12 month old only had breastfeeding 3 x's!

Anyways, I consider myself a pretty experienced, educated breast feeder. Luckily, I know enough to ignore bad advice. But, it bothers me that this is the woman the county is using for infant nutritional advice. Another, less certain mom, may actually take this horrible advice.

I want to call her out on giving this bad advice, but I'm not exactly sure how to go about it. Any advice?


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Last edited by Xerxella; 11-22-2015 at 07:04 PM.
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#2 of 8 Old 11-23-2015, 08:01 AM
 
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Depending on where you live and if the nutritionist was a registered dietitian, you could follow up with the state or provincial regulatory board and file a complaint about her advice not being consistent with accepted guidelines as well as offering advice outside her scope of practice.
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#3 of 8 Old 11-23-2015, 09:31 AM - Thread Starter
 
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Here's the Weaning article and the "Sample Meal Pattern for Older Baby"


I'm still shocked by it, although I shouldn't be, I guess.


She puts RD and LDN after her name, which I assume is for Registered Dietician and Licensed Dietician Nutritionist. We live in Illinois, USA. I wouldn't know how to go about filing a complaint against her. I'll have to look into it. Anyone with more details would be much appreciated.

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#4 of 8 Old 11-23-2015, 09:34 AM - Thread Starter
 
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Trying again: (They don't look right to me, but when you click on them, they open.) The first one is the sample meal plan and the second one is her letter to me for weaning a 6-12 month old. (Which I never asked to do....)
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Sample Meal Pattern for the Older Baby.pdf  

Page 1 Weaning.pdf  

Page 2 Weaning.pdf  


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Last edited by Xerxella; 11-23-2015 at 09:37 AM.
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#5 of 8 Old 11-24-2015, 07:54 AM
 
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Hmm..she may not realize that her handout is outdated even though she's using a book excerpt from 2000. Ellyn Satter is pretty widely respected but her advice seems to be based on cultural norms of the day and not scientific evidence. I would reach out to the dietitian first and explain your concerns that her handouts are not based on current evidence and best practice, referring to the AAP and WHO guidelines. And express concern that they include sleep advice which seems beyond her area of expertise. There are plenty of other resources out there to provide parents.

If you don't get a favorable response, you could follow up with the regulating agency and file a complaint http://www.idfpr.com

I'm not from the US but I'm guessing the code of ethics and responsibility to stay current is similar to Canada. Anyone else have suggestions?
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#6 of 8 Old 11-27-2015, 06:23 PM
 
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I think you will get very little traction with taking 'professional action' but maybe this: 1) send her a handout or 2 with the practice guidelines, from WHO or AAP or The Academy of Breastfeeding Medicine. Tell her you were uncomfortable with her advise because it went against both what you felt was right as a parent and what the leading authorities say on the matter. And, yes, let's not get into Ferberizing b/c you won't find very good support from AAP on attachment parenting sleeping beliefs. 2) mention to whoever referred you to her that you felt her info was incorrect and discouraging breastfeeding, which was key for your baby's health as a preemie (at least, I know I felt that way about my preemie!). Show them her handouts vs the correct info from above. Advise the referral person that you do not suggest sending breastfeeding mothers to her. If it was a state health person, they may particularly care b/c WIC, etc these days is really pro-breastfeeding, and if it was your pedi hopefully they care about this too (but, I know there are pedi's who don't care about breastfeeding, unfortunately). In your letter to the RD, inform her of this action.

This is what I would do if I was feeling this way. Or at least, what I would set out to do, then get distracted when I couldn't find a pen, until I found that the little nursling was poking it in her mouth, then get mad when I took it away, and then I'd nurse her to calm her down... And wait, what was I doing again?
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#7 of 8 Old 11-27-2015, 06:31 PM
 
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The menu might match AAP Guidelines, although they aren't in front of me.

The other handout makes sense if you take out the word 'breastfeeding.' I think she offers reasonable advise for bottle feeding parents. I wonder if this woman ever nursed an infant >6 months b/c it doesn't sound like it. I think we try to use inclusive language sometimes but clearly a child walking around with a bottle of juice at 14 months old is a different story than a 2 year old who nurses when upset or oberwhelmed (or, hey, even just thirsty). Just because this woman wrote a book (named after a guns and roses song) doesn't make her any form of authority worth propagating.
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#8 of 8 Old 12-15-2015, 05:53 AM
 
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A quick glance at the AAP guidelines is that they're a bit obsessed with introducing a cup at 6-9 months. Not just to replace bottle feeding (sensible for jaw development) but they also say to express milk into a cup and don't give any indication to do it as an occasional thing.

Ugh.
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