… is the answer to the question, “How was your holiday?”

Last week, we spent five days at a cottage, on a farm, about two miles away from the road, and about 4 miles from Coniston. The fact that it rained almost constantly wasn’t a problem. We’re not silly people - we more or less expected rain in the lakes in late November. We have adequate waterproof stuff, and we’re much more wander-around-the-town types than trek-across-the-fells.

The problem was that we were twenty miles from the nearest A and E when Daisy came down with croup, and the GPs in the local area are a bunch of doddering quacks.

We arrived on the Monday, and settled into the cottage. It was lovely - small, but not too small, directly overlooking the main sheep-fold, with interesting views of sheep being herded around for various mysterious purposes. Daisy was delighted that her bedroom had a window at more or less floor-level, and the double room was plenty big enough for Henry’s hammock as well. It was very nice, and I’d go again.

On Tuesday, we went to Keswick, to wander around the town, since I’ve never been. It’s a nice little town, only slightly marred by the whingey awkwardness of my daughter (whose zenith that day was to knock over a display in a shop, and then shout and cry at the generously philosophical assistant for picking it up again, because she wanted Daddy to do it…). I wondered then if she was coming down with something, but she could have just been tired.

Anyway, in the early hours of the next morning, she woke up with a raging temperature, a classically croupy cough, and the harsh wheeze which is the difference between croup you worry about and croup you don’t. We weren’t in a wild hurry to take her twenty miles to Barrow/Kendal, so we went for some old-fashioned nursing remedies - we filled the bathroom with steam, gave her paracetamol for the temperature, and tried to get her calm enough to be able to breathe properly.

It only kind of worked, but she calmed down a bit, and we decided to put her back to bed, with one of us sharing the twin room with her. Kevin drew the short straw, which turned out to be shorter than he realised, since the excitement of having Daddy in her room make her refuse more or less point blank to go to sleep.

One of the things with croup, is it’s worse when they cry, so the medical types advise keeping her calm. Poor Kevin didn’t want to have the stand-off with her, but as a result, she didn’t get back to sleep until 6am, and at one point I believe they were downstairs watching Shrek at 4am.

The next morning, we took her to the local GP, and told him what had happened. She was still coughing, and still wheezing a little, though going out in the car helped a little. The GP, unfortunately, was an idiot. We made a point of telling him that she’s had it before, and that it was treated at Alder Hey with oral steroids. He said, “Hmmm… yes, steroids is a common treatment,” but then prescribed antibiotics. A bit bizarre - croup stems from a virus, not a bacteria, so antibiotics are a waste of time. Daisy’s first ever set, too. He also prescribed linctus, which is tantamount to spending NHS money on Lockets.

We duly administered the prescribed treatments all day, whilst sitting around the cottage recovering from the bad night, but by tea-time, it was becoming apparent that, not only wasn’t it working, but she was starting to deteriorate with the approach of night time, so we whisked her back - or at least, whisked her to the guy who covers for the first guy on Wednesday afternoons, when he’s off.

He seemed more willing to admit that steroids were the appropriate treatment, but didn’t prescribe them on the grounds that he didn’t stock them in his dispensary (bizarre country doctor thing, dispensing you own medicine). “It sounds worse than it is,” he said. “She’ll be fine.”

Hmm.

On the second night, I shared her room (since I am proven to be a much less exciting person), and was woken up about every hour and a half, either because she was coughing and needed a drink, or because the extra fluids had caused her to wet the bed (with the natural effect that I spent most of the night in a wet bed - just as it was drying out, she wet the other one, and we swapped back. Who’d be a mum?).

So on Thursday morning, we took her back to the first GP again, and came back with a Ventolin inhaler, which also had no noticeable effect.

We gave up on the local health services at that point, and said that if we didn’t have a significantly better night, we would bring her home in time to see our own GP on Friday afternoon. That night was a little better, but not much, and in any case, it was pouring with rain the next morning, and we decided that appeal of trudging around Ambleside in the rain wasn’t sufficiently great, when set against the option to get Daisy to a competent doctor. So we paid the lady, packed the car, and came home.

It was a huge relief to sit on my own doctor’s office, and have her instantly start behaving as if not being able to breathe properly does, in fact, matter.? She heard the wheeze as soon as we walked through the door, and actually thought it was Henry, the very idea of which nearly gave her apoplexy. Discovering that it was actually the three-year-old calmed her down a little, and she started to prescribe the steroids that I’d been trying to get hold of all week, but then decided that she wanted her on a nebuliser, for which we had to go to Alder Hey.? So she made a call, wrote a referring letter, and send us away.

The paeditrician at A&E reckoned that ventolin - in the form of inhaler, or nebuliser - doesn’t help with croup, and just gave her the steroids anyway, so all that achieved was to postpone the treatment for another two hours, but if it meant that the GP could sleep over the weekend, I don’t really hold that against her. Though if I end up in the situation again, I shall argue with her.? I think the fact that it was Friday night went into her decision making, though - if she could have said, “Bring her back in the morning,” I think she might have done that instead.

So, two hours at the GP, followed by three at Alder Hey, made for two very tired children, and two equally tired parents.? And no, not the greatest holiday we’ve ever had.? Still, at least the wheeze has gone, now.

I’m a bit blog-prolific, this week, aren’t I?

See? Idyllic pace of life,
immaculately well-organised living
space, and no room for anything
that?s not totally necessary?

Some days, I drive past developments of two bedroomed apartments in the city centre, and desperately want one. Especially the sort that are converted Victorian warehouses, by the river. I’ve always been this way. Tiny cottages in picturesque village locations also draw me, as do canal boats, and I’ve only just worked out what the appeal is.

I want to run away from my stuff.

I want to maintain my four bedroomed house full of things I don’t quite want to throw away, but actually live in tidiness and minimalist simplicity somewhere else. It’s not that I’m seeking to leave my husband and/or children behind. It’s just all the toys and computers and bits and bobs that I’d rather not look at all day. So I’d sit in peacefully uncluttered serenity, but come home whenever I wanted something.

I really need to address my lifestyle, don’t I?

There is something to be said for doctors.? Doctors are trained and authorised to make decisions about things, in contrast to nurses, including health visitors, who are trained and authorised to trigger procedures.

Two weeks ago, I took Henry back to the HV for yet more jabs, and yet more weight monitoring, and he’d crossed another line.? He’s now gone from the 91st centile to 50th, in about eight weeks.? I was so sure that he’d grown enough, this time.? I’d spent the whole of the previous day feeding him at 90 minute intervals, in a bid to make him as heavy as possible.? Besides, he had to have grown - he was so obviously healthy, and alert, and etc, etc, how could he not be growing?? I just wanted her to say, “That was a blip, he’s fine, off you go”.? But of course, she didn’t - he’d crossed another line on the chart, and so she began.

“On the one hand, he looks and seems perfectly healthy. ? But on the other, it would be remiss of me not to respond to this lack of weight-gain in some way.”

I must have given her a look, because she said, “I know you’re angry…”

I hate being handled.? Somebody at some point has trained her to say that when people give her the look I’d just given her; she was trying to make me feel Heard, and Empowered.? I loathe that.? You need more grace than that to mess with my head without irritating me intensely.? My dad was a counsellor, and I learned pretty robust anti-counselling defences at a fairly young age.? Besides, she was wrong.? I was angry, but the look was about trying not to cry.? I’d tied myself up in knots trying to make my feeding of him better, somehow, and I’d proved myself to be a dismal failure - a failure as a mother, not least.? She denied that it meant my milk wasn’t good enough, but really, if that wasn’t what she was saying, what was she saying?

She flirted with referring him to Alder Hey for Failure to Thrive, but I think that even she saw that as ludicrous.? He is thriving, he’s not losing weight, he’s just not as fat as she would appear to wish.? So her second suggestion was that I take him to the breast feeding clinic at the Women’s Hospital.? This did not delight me.

I’ve been to the breast feeding clinic before, when Daisy was tiny - not because of her growth, but because of the acute pain and bleeding in my nipples.? The thing is, I think I’ve heard pretty much everything they are ever likely to say about breast feeding.? I can recite their positioning mantras, and was reciting them all through Henry’s first week, when it was so unspeakably painful.? But he’s four months old, now, and there’s nothing wrong with our positioning.? I can’t imagine how breastfeeding could suddenly stop working, or what they would say in response to such a thing.? I mean, if I’d been ill, or stopped eating, or taken up some kind of prescription or illegal medication… yes, these things could affect your milk.? Just trotting along in more or less the same way as you had for the previous two months, however, is a bizarre way to make milk supply problems.

The extent of my desire to drag my baby and my three-year-old to the LWH on Thursday must have shown on my face, because her next suggestion was, “I could ask one of the GPs here to check him over.? Would that be worth doing?”

I said, “It’s worth doing if it means I don’t have to trek all the way out to the Women’s later in the week.”? So off she toddled, to find a GP.? The one she found was in the next room, so I gathered up Henry and Daisy, and took them next door, and the minute the door closed, the doctor said, “Don’t tell her I said this: I’m sure he is fine, and I’m only doing this to get her off your case.”

Cheered almost immediately, I chatted to her a bit more, and learned that her own first baby plummeted down the charts, to the extent that she was referred to? Alder Hey, and prodded and poked, and she was fine.? She was a big baby, who was destined to be a smaller-end-of-average person, and there is no way to get from one of those points to the other without crossing lines on the growth chart.? She talked about bell curves, and the fact that no-one wants to be at the the extreme ends of the chart; that if he’d stayed on the 98th centile, he’d almost certainly be obese, and/or suffering from some kind of enzyme/hormone deficiency; that the graphs are based on bottlefed babies anyway; that Health Visitors are trained to prioritise growth, because the profession was established to fight malnutrition in babies, but that isn’t the evil of modern culture - quite the opposite.? She basically said that my baby was healthy, and everyone else’s are overweight!

She listened to his heart, because she’d said she would, and gave some cursory poking, but was perfectly happy with him.? So then we talked about the Health Visitor.? Now, I’m sure there are many worse HVs in circulation than mine.? As I’ve said before, she’s a perfectly nice woman. But I really, really didn’t want to keep bringing him back to her, to be weighed, sighed over, criticised, and to walk away needing to eat chocolate, drink wine, and sob on Kevin’s shoulder at how inadequate I appeared to be.? I felt like I was caught in a vicious cycle, and everything in me wanted to take Henry out of there, and just never take him back. As long as no-one weighs him, I believe he’s fine, so stop weighing him.

The doctor cut a deal with me.? Incidentally, she admitted that she never took her second baby to be weighed, and was much better off as a result, but we decided that I would bring Henry back in a fortnight, just to check, but I would bring him to her, in surgery.? I’ve no idea what she told the Health Visitor - she went off, either explained, blamed me, blamed her, or fudged the thing somehow, then came back and told me it was fine.? And that’s why, today, I took him to the surgery, to see the doctor for weighing, instead of taking him to clinic tomorrow.

She was torn.? He’s gained some weight, but not as much as we were all hoping - enough to allow us to say, “A blip.? Ah, well.” ? However, she still believed everything she said two weeks ago.? She added that he’s not malnourished, or underweight in any sense - he has creases in the fat of his legs, his ribs don’t stick out, he’s clearly getting as much milk as he needs.? She said, “There is no question of him being insufficiently fed,” which throws the breast feeding clinic out the window, really.? She said, if he was referred, the hospital would test him for things like cystic fibrosis, and other diseases that would impair his growth.? But she also said, when I asked her, that if he came back in two weeks or a month having crossed the 25 centile line, but still looking as healthy as he does now, she still wouldn’t be inclined to refer him.? If he was ill, he’d be, well, ill somehow.

That led to the question, why are we monitoring his weight at all?? She toyed with telling me to bring him back in a month, but in the end, we left it up to me.? I mean, obviously, it’s up to me anyway, but it was “Bring him if you want to, or if you’re worried, but I’m not saying, ‘I definitely want to see him’.? And if you do bring him, I won’t assume that you suddenly are worried - don’t let that put you off.? If you like, bring him, we’ll have a chat, and not weigh him at all.”? (I’m busy today, I have to take Henry to the doctors to not be weighed…).

So, I’ve done it.? I’ve shaken off the over-attentiveness of the NHS.? If he seems ill, I’ll take him to doctors, and if he doesn’t I won’t.? That sounds so basic and obvious, I’m wondering why it took so long to get here.

Kevin pointed out that the lines on the graph imply that babies start in one place and grow steadily from that point.? There’s no evidence, on the chart, that the top 3% of babies at 2 weeks and the top 3% at four weeks are the same babies.? The line is arbitrary - why are we trying to make him follow it?

The other thing that occurred to me, this evening, is that the GP wasn’t saying, “There was a problem, it’s gone now.”? She was saying, “There was never a problem.” She was categorical that my feeding him wasn’t at issue, which cuts across the things that the Health Visitor seemed to be implying, with all her “How do you feed him” questions.? There’s nothing wrong with my feeding - with my milk, with how often, with how long, it’s all fine.? Just like I always knew it was, until they knocked the stuffing out of me.?? In the interim, I’ve been trying to feed him more often, in the hopes that he’d put more weight on, and get us both off the hook.? And I seem to have succeeded in taking a baby who happily fed once every three hours, and turned him into one who needs to feed every 90 minutes.? It’s not affected his weight gain, so presumably he’s taking half as much milk, twice as often, with only one effect - to make feeding him more inconvenient.? Some babies need to feed that often, because of how much milk is available at one time, or because of how much milk they can fit into their tummies.? Mine I’ve just trained that way, which is unspeakably stupid.

Still, if I can edge him one way, hopefully I can edge him back again!

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.

HiddenMy 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?

HiddenThen 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.

I’m thinking of throwing away my clothes. All of them - or at least the vast majority of them. I have very, very few things that I like, and I’m sure that when I step back and think about it, I know what I ought to be wearing instead. I’ve watched enough Trinny and Susannah (and whoever the two birds are who do it now) to know: I have good boobs, I should wear V-necks, and better quality bras than I do; I am fat, but I do have a distinct waist, and should aim for fitted things that show it off, without stopping me breathing; I have rubbish legs, and should go for below-the-knee skirts, and trousers*; the tops of my arms are particularly fat and horrid, so for pity’s sake, stop with the short sleeves - three quarter length is best.

Also, I suit red, dark blue, purple, and cerise-in-the-winter (bright pink on a hot day just makes me look flushed). I absolutely do NOT suite light blue, turquoise or any kind of aqua-marine sort of colour. I can get away with browns and beiges, but not orange, and greens should be murky, not too bright.

You see? I get it. So how come I still buy short-sleeved lemon t-shirts?

* Note: not sure about trouser shape. Must do more research.

Phoenix insurance just sent me a fairly random letter, suggesting that my income protection insurance might need reconsidering, since I’ve had it for seven and a half years, and the two-thirds-of-my-salary payout may no longer be appropriate.

Since it’s nearly two years since I received a salary, I’m thinking that two thirds of it is going to amount to zero, and that I should stop giving them ?13.48 a month, ASAP.

Note to self: get life in order.