Hi All,

 

I think what we need to look at here is simply that test weighing is a tool
that needs to be used appropriately.  I use test weighing at every consult -
it is mainly for informational purposes and that information is put together
with all the other information I collect during the consult.  The mothers
love it - whether it is to see that their baby actually IS getting milk or
is NOT getting milk - in both cases I have had mother's say that they were
glad to know because it proved their gut instinct was correct.  I have NEVER
had anyone say they did NOT appreciate the test weighing.

 

I have had situations in the past where mom and I heard audible swallowing,
(not with a stethoscope - which I now use) baby seemed satisfied - BUT there
was NO intake of milk per the scale!  This was not a malfunction of the
scale - rather it sounded good, looked good, felt good, but wasn't.  With
these cases I have mom use a scale for 24-48 hours, pump afterwards and see
what we get (since, as I tell them - this was just one feeding) and to make
sure that baby gets X-amount of milk in 24 hours.  With the scale we have
caught some major milk supply issues before baby was compromised (mom was
unable to pump enough (if any) milk to meet baby's needs).  

 

There are times when I KNOW a mom has plenty of milk (she'd been pumping
because baby was not nursing well which is why I was called).  Use the scale
- watch the baby - looks good, sounds good, feels good - hear the swallows,
baby comes off seeming satisfied - but minimal intake.  This leads me to do
a suck evaluation (always with a flow of milk) and there we have the issue -
baby has something going on with the suck.  Had I just watched and listened
and used only my other tools of observation I could have potentially missed
a serious issue - Mom feels validated that her gut instinct was correct and
feels relieved that she was doing the right thing by feeding her baby the
milk she had been pumping.  We work to correct the problem and mom and baby
are off and nursing successfully.  I would say that for me, the scale is
usually used to simply confirm that baby is doing well (at that feed) and
then mom is relieved and given all the information she needs during the
consult to make sure baby continues to do well.  We also get a baseline
weight for that day to monitor weight gain by.again to ensure baby is
gaining well at breast.  

 

The bottom line, for me - there are a lot of tools we use to determine if BF
is going well and how well it is going.  We need to use all tools
appropriately.  There is no one tool that will work for every situation and
there is no one (appropriate) tool that will always cause problems.  For
every single tool we utilize there are ways to use it appropriately and
inappropriately.  It is up to us as professionals to make sure we are using
our tools correctly at all times.  We have had other discussions in the past
about other tools with some of us being dead set against using 'X-Tool",
others being all for using it all the time and still others being middle of
the road - the scale is no different.  The tools I use in my practice on a
regular basis - my stethoscope, my scale and most importantly my education
(eyes and ears included).  Tools that come out every now and again only when
absolutely needed - nipple shield and SNS.  My clients get a folder with
about 15+ handouts that include information to keep them informed on
appropriate weight gain, growth and what is normal for the first 6 months.
There is also info on milk storage, baby's body language, hunger cues,
cluster feeds, fussy evenings, good parenting books.Those are the parents
tools.It is up to us and them to utilize all tools available appropriately.

 

Warmly,


Jaye

 

 

 

 

 

 

 

 

 

 


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