Magda wrote:
"Recently there has been discussion of the practice of test weighing, which
I know is a staple of LC practice for many of you.  Here in the UK we do not
do this, and even for professionals who are generally out of date it has
been accepted for some years that this is not to be done in order to assess
feeding.  So I am interested in seeing this research -- which I am just now
printing, so cannot comment on the full study.  I am sure that those of you
who use this technique will also be interested in knowing about this paper."

I will weigh in here, in the hope of beginning a discussion about the value
of widespread test weighing.  Here in Australia, test weighing is all but
unheard of and if a mother reports that a health professional has done or
recommended a test weigh, it is a red flag that suggests said professional
is not well versed in lactation management.  (And I have never seen a scale
accurate enough to do this sort of weighing anywhere except a NICU, where
its use might well be appropriate.)  This sort of widespread test weighing
fell out of favour at least thirty years ago.

We all know that the volume of a breastfeed varies wildly over any given
twenty four hour period and between mothers. We also know that there are
good ways of assessing adequate milk transfer that do not invlolve kowing
the volume of milk transferred.  The article Magda mentioned refers to
listening for swallowing sounds but we can also observe a change in the
infant's posture, an open hand, a relaxed facial expression and most
importantly, output.  Any mother can be taught to observe these signs.
Every mother should be.  Reliance on scales disempowers mothers and I would
be very concerned about clinical decisions being based on a test weigh
conducted in a health professional's office.  (Although I am sure that one
test wiegh would not form the basis of any LCs decision.)  I am sure we are
all aware of what can happen to a person's blood pressure readings in a
doctor's office. And we know that stress hormones inhibit the milk ejection
reflex.

I fear that routine test weighing disempowers mothers by attempting to
quantify a process that women were prefectly capable of before Medela
invented the babywiegh.  It suggests that breastfeeding is fragile,
unpredictable, and unknowable and I fear that it makes breastfeeding too
hard for ordinary mothers to do.

I had a conversation with Cathy Watson-Genna about this when she was out and
I understand that some of the dyads that LCs see present with conditions
that make observations of adequate milk transfer difficult, if not
impossible and in these cases a test weigh can be reassuring for a mother
and can facilitate her continuing to breastfeed where she otherwise might
not.  This is not the kind of test weighing I am referring to when I express
a fear that it disempowers mothers.  The kind of test weighing that I fear
is the routine, expected weighing.  The kind that might make mothers feel
like they are taking a test to determine if they are good enough producers
to be allowed to continue ...

Nina Berry BA/Bed(Hons) Dip Arts(Phil)
Breastfeeding Counsellor
PhD Candidate - "Ethical Issues in the marketing of 'Toddler Milks'"

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