Posted by My OB said WHAT?!?.
Oct
15
Posted by My OB said WHAT?!?.
“Weight Watchers Has A Nice Program For Breastfeeding Mothers.”
“Weight Watchers has a nice program for breastfeeding mothers.” – Certified Nurse Midwife at mother’s 6 week postpartum visit, after the mother stepped on the scale.
There are 35 comments to this post.
I don’t see much wrong with this one, unless the mother was really heavy. Most women are focused on healthy weight loss when they’ve just had a baby but if they are breastfeeding, they are afraid to diet because they don’t want to compromise milk supply. She was just saying that Weight Watchers might have some good pointers for keeping milk supply up, while losing weight while the subject of weight had come up, since she’d stepped on the scale.
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BeckyJ Reply:
October 15th, 2011 at 10:32 am (Quote)
And I understand that the patient might not have wanted it discussed if she didn’t bring it up, but still. I don’t know if I find it that offensive, since weight loss and breastfeeding are so relevant to a newly postpartum mother.
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Robyn Reply:
October 15th, 2011 at 11:14 am (Quote)
While I completely agree with you (in fact in the breastfeeding groups I’m in WW is the most commonly recommended weight loss plan), there could be other things going on that we don’t see as well. There have been so many posts on this site where during pregnancy the care providors are freaking out about how heavy they are and these women are tiny. This mom very well may have been like my mom who was walking around the postpartum floor wearing her pre-pregnancy jeans that fit like a second skin. Or she could just be a mom who is very sensitive about her weight. However, in general, I don’t see a big problem with this comment as weight loss options are a common question at the 6 week postpartum visit.
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Health care professionals have a responsibility to discuss healthy weight with their clients whether the clients want to hear about it or not. Kind of like any other health issue. Maybe the timing was a little off on this one, but overall, it sounds like a nice suggestion.
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I was personally told not to try to start any kind of diet while breastfeeding. While it COULD be a nice suggestion, I think 6 weeks PP is a little early…I didn’t even start noticed weight coming off until about 3-4 months. Maybe it’s just me and maybe I’m just in a hormonal, pregnant lady mood, but this would irritate me big time. :/
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Robyn Reply:
October 15th, 2011 at 11:21 am (Quote)
There is a big difference between the socially understood “diet” and a change in eating habits. The “diet” is a temporary change in eating habits meant to promote rapid weight loss. “Diets” are bad because they can affect milk supply, plus there are toxins stored in your fat cells that pass through the milk, so rapid weight loss means a lot of toxins going directly into your baby. Once you stop your “diet”, the weight quickly comes back on and usually with interest. A change in eating habits, such as is promoted by Weight Watchers, is a lifetime commitment meant to help you make healthy food choices that allows weight to come off slowly. Their breastfeeding program gives the women a little more leeway in their diet so that they can still lose the weight while being able to maintain an adequate milk supply.
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I had a homebirth, but used this OB office for lab work and stuff. Although I didn’t know the CNM well, my history included openly that I had had a past with eating disorders. When she set the scale to max. 150lbs. I said, “Oh no, I’m up there”. and clicked it to the next increment. She weighed me, I was +29lbs. from my healthy pre pregnancy weight, and she said “OH! You ARE up there! (looked me up and down) Well….weight watchers has a nice program for bfeeding mothers”. I felt like someone slapped me across the face. I just had a baby and felt great! Of course I have weight to lose. I was also running 10k’s in my first trimester. I wasn’t asking for advice and being a PP appointment, I wouldn’t assume she would offer this information unsolicited. I was basically there to get contraception. She disagreed with my choice of a diaphragm and asked me “If I would want to jump off a bridge if I found myself pregnant in 6 months?” She continued to push for the IUD and when I clearly expressed that the diaphragm was the right choice for me she said “Why don’t you go home and do your research” and sent me out with NO contraception. AND yup there is more here) the last thing she asked was about my mental well being. I began to explain that I was really doing pretty good. (this was my 3rd baby) I began to go on and after a few moments she looked at her watch I paused and said “Look, if you say you’re ok – then we’re done here. If you’re not – you should ask for help”. I looked at her, smiled, and said – We’re done here.
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krp_2000 Reply:
October 15th, 2011 at 12:32 pm (Quote)
Wow – I think that WW comment was the nicest one she made!! What a jerk. I hope you complained about her to her supervisor (if there was one)!
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BeckyJ Reply:
October 15th, 2011 at 3:21 pm (Quote)
I’m sorry for your treatment by this woman. It wasn’t right, and while I thought that her comment wasn’t that bad, when it’s bundled with all the other “gems” she threw at you, it’s horrible and I’m sorry. 
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Trisha Reply:
October 15th, 2011 at 3:33 pm (Quote)
You said ““Oh no, I’m up there”. If I asked somebody to step on the scale and that was the comment made by the PATIENT, I would infer that she had concerns about weight. In this instance, the CNM is acknowledging that the weight can come off safely, even while breasfeeding. I see nothing wrong with this comment at all.
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Amadi Reply:
October 15th, 2011 at 6:43 pm (Quote)
What’s wrong with the comment is that no one asked this person for weight loss tips and you never give unsolicited weight advice in either direction to a patient with a history of eating disorders. Read the chart. Act accordingly. This is the first responsibility of a medical provider.
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jaed Reply:
October 15th, 2011 at 7:30 pm (Quote)
You said ““Oh no, I’m up there”. If I asked somebody to step on the scale and that was the comment made by the PATIENT, I would infer that she had concerns about weight.
Er… why? The patient in this case knew her approximate weight and corrected the CNM’s inaccurate guess by moving the scale calibration while saying “I’m up there.” That indicates that she knows how much she weighs, not that she’s “concerned” about her weight and anxious to discuss it. Knowing her weight might just mean that she knows what it is, not that she has particular concerns about it.
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Regardless of my personal history and how that might further effect me – I do not think a postpartum mother should be given unsolicited advice on weight loss. The mother has not gained weight b/c she hasn’t taken care of herself. It was for good reason and she deserves the opportunity to allow her body to rebound. We live in a culture where body image effects many and i feel it’s inappropriate to address a brand new mother with the reminder that she’s now overweight. There is a term “momorexia” I’ve seen, b/c women are being held to look like swimsuit models within weeks of giving birth. Why would a health care provider not consider the psychological well being of her patient? My Past CNM’s from previous births – wouldn’t even discuss it with me when I asked. “Don’t worry, give yourself time, you just had a baby”. That to me is a message reminding a woman to honor her body for what it just did. How can a woman be kind to herself if we can’t be kind about it and start sending her messages to “get fit’ while her body is still recovering from growing and birthing a baby?!
No, I think if a year went by and there was no change it would be appropriate for a care provider to address one being overweight for the sake of one’s health, but not at a 6 week check. And not suggesting WW. That also implied that I must be unknowledgeable about caring for myself and would need outside help and tracking if I was going to lose the weight. An unfair and offensive assessment at a 6 week check that was made by looking me up and down
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C.Pratt Reply:
October 15th, 2011 at 3:36 pm (Quote)
I agree completely, at a 6 week checkup, with an OB office (not a weight loss specialist), without any request for the information, each aspect of that makes it worse and worse- It was bad enough to start with. Now, if you had asked, if she was trained in that field, and if you didn’t have a baby who by all rights should be nursing which means your body is a temple that should be lavishly nourished… even then the subject would be handled with care and sensitivity by anyone who wasn’t a bee-och. Sorry you were treated this way and I hope you were able to set it aside and not suffer any negative affects.
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Medical professionals should never encourage disordered eating and they should never encourage temp weight loss via eating restriction (which is what Weight Watchers programs are). This is unhealthy behavior regardless of what weight you’re at. People do it anyway and they have a right to do it if they want, but medical professionals have no business suggesting it. (Not that this stops the great majority of them, but still.)
Particularly when talking to a breastfeeding mother, who will adversely affect her baby if she starts restricting.
And also particularly when talking to a new mother, a group which is known to be especially vulnerable to body shaming, for all kinds of reasons. Midwives, who care for pregnant women, should be particularly aware of this, not oblivious.
Aiiiieeee. Fail all around here.
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Bonita Reply:
October 15th, 2011 at 2:23 pm (Quote)
I don’t think you have done your research on Weight Watchers, particularly their nursing program.
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Amadi Reply:
October 15th, 2011 at 6:47 pm (Quote)
And if you did your research on oh-so-successful WW you’d know that they’re part of the $6 billion diet industry in this country that has a success rate hovering in the single digits. You’d know that their “healthy” programs are just calorie restriction, like any other diet, whether you call them “points” or “widgets” or “fizzbangs.” And you should be asking yourself who benefits when medical professionals try to steer their patients to a for-profit company, unsolicited.
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L Reply:
December 12th, 2011 at 4:27 pm (Quote)
I know I’m coming in late, but I DID do my research on the WW nursing program, and I followed it nearly exactly, and I STILL lost almost all of my milk (at 4 months). It was one of the factors that led us to switch to formula–which is a long deal that I don’t want to get in to right now, but that I don’t necessarily regret. Just throwing that out there.
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BeckyJ Reply:
October 15th, 2011 at 3:19 pm (Quote)
I agree with Bonita. Healthy diet IS about restriction, to an extent. It’s called healthy portions. I’d rather count calories on myfitnesspal.com than do weight watchers, but that’s just me. 
I’ve been counting calories on myfitnesspal for over a year, lost 15 lbs, got pregnant and have gained 25 lbs. So, saying that restriction during pregnancy or postpartum isn’t good is completely false. It’s all about doing it healthily.
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Wendy Reply:
October 15th, 2011 at 4:08 pm (Quote)
But if you read the OP’s pink story, you’ll see her history of eating disorders, which requires a much, much different clinical approach.
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BeckyJ Reply:
October 15th, 2011 at 9:49 pm (Quote)
It requires HEALTHY calorie intake with close watch of a nutritionist or therapist. Not much different if you ask me.
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I used to be in Weight Watchers. They suspended my membership while I was pregnant. The Leader told me NOT to come back until three months after the baby was born. La Leche League says to wait at least 2 months. To my knowledge, this is the most medically sound recommendation so that women have time to establish a good milk supply for their newborns. So the first concern is that a CPM would clarify this statement with a reasonable time frame and NOT make a mom feel like she has to rush out to her soonest WW meeting while only 6 weeks post-partum.
Second, there’s this little thing called tact. I wouldn’t even *mention* weight loss on this visit, but instead discuss good nutrition with the mother. “Now I understand that you’re going to be extremely busy nursing and caring for this little one. But that’s where a lot of moms run into trouble; they forget to look out for themselves. Whole grains, healthy sources of protein, and fresh fruits and veggies are all imperative during this time to keep up your energy and nourish your baby. Exercise it also really important. Even something as simple as a brisk daily walk with your baby can help fight off the baby blues.”
Keep in mind that a skinny mom who “bounces back” to her old body may have a really unhealthy diet and lifestyle (smoking, junk food, etc), while an overweight mom may be taking daily walks and eating nutritiously. Our culture’s irrational fear of fat people tends to cloud this simple fact.
Finally, Weight Watchers is contraindicated for women with an active diagnosis of bulimia. In fact, they refuse to take you if you are bulimic. Unless the OP was *fully* recovered, the nurse had a duty to RTFC (Read The Freakin’ Chart) and ick-snay on the talk of iet-day.
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The Well-Rounded Mama had this to say,
Oct 15, 2011 @ 4:07 pm (Quote)
Long-term weight loss success is unusual….not unheard of, but pretty uncommon. WW is generally a reasonably sensible program, not too extreme, but doesn’t have any better long-term success than any other program, whether you call it a diet or a lifestyle change. Most lose for a while, then regain, often to higher than they began. So how beneficial is that really? (see Mann 2007 http://www.ncbi.nlm.nih.gov/pubmed/17469900)
That’s why WW is such a profitable company….all the repeat clients. That said, it does help some women who have been average-sized return to that more easily, and helps some who have serious eating issues or poor habits recognize that and get help. OTOH, it also adds to a lot of women’s eating-disordered behavior, and many have yo-yo’d their way up the scale via WW. So it can be a mixed bag.
Love WW or not, I have reservations about recommending it to a 6 week postpartum woman because starting caloric restriction too early can impact bfing supply in vulnerable women. OTOH, some do fine. But it’s not something to do in someone whose milk supply is iffy, which is a question this midwife should have asked before recommending it.
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Wendy Reply:
October 15th, 2011 at 4:10 pm (Quote)
http://www.ncbi.nlm.nih.gov/pubmed/17469900
I tried to click on yours, but it didn’t go through with the parentheses.
Great post, btw.
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Is it a usual thing for doctors/midwives to weigh you at your 6 week pp visit?
I’m American, have only had one baby, but the entire pregnancy happened in Australia. I was surprised that my OB weighed me exactly once, at my first visit. Somehow I’d been expecting weigh-ins at every visit, but that didn’t happen. And no weigh-in at all at the pp visit.
(I realize now that I was also lucky that there were no VE’s until one after my water broke. And then very few during labor. I agree with the people who ask the question of how can we change the model of maternal care in America? Because it does seem like other places have models that work better…)
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Ugh .. Sort-of similair to what happened to me, I just gave birth to my VBAC baby, after a super quick (3hour 5 mins) labour, and I had been nursing my baby for 2 hours straight, she was just so alert and happy to eat, and I was waiting to be stitched as I tore, when the midwife came in to check on me, i asked her for a sandwhich because I was hungry after using energy on giving birth, so she went and got the sandwhich and when she gave it to me she said “Make sure when you’re hungry from now on you snack on healthy foods, you have a lot of weight to lose” .. I had literally just given birth and she was talking about my weight ugh.. I am overweight, but not obese, I’m 80kg, not sure what it is in pounds.
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Unless mom specifically said something about her weight, and I’m guessing she didn’t since this post is here, the midwife shouldn’t be saying anything. It wouldn’t have killed her to wait until the mom was off the scale and it was on the Q & A portion of the visit to bring up weight and her concerns for the mother.
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