I didn't mean to suggest that Magda's article was specifically about test weighing. I used the subject tag of "test weights" because I was responding to Karen Clement's request for info about test weighing by recommending Magda's great article as a nice overview. The reference is: M Sachs, S Oddie: Breastfeeding -- weighing in the balance: reappraising the role of weighing babies in the early days, MIDIRS Midwifery Digest 2002; 12(3):296-300. As I read Magda's article, I don't see it coming down against the practice of weighing at all. Rather it calls for more focused normative research (desperately needed) on issues relating to early weight loss in bfg infants and on the practice of weighing. The article describes the often poor methodology used in collecting weight info, the inaccurate scales, and the lack of research documenting when and how weights might be most effectively performed. Magda makes a statement I agree with completely: "If babies are weighed, the results should inform practice." With an accurate scale, a good reason for doing a weight check in the first place, and sensitive presentation to the mother, the information can definately inform management interventions in my experience. Magda also states (with regard to the perception that weighing stresses parents): "A Cochrane Collaboration review of growth monitoring discovered an astonishing lack of evaluation of the effects on parents of weighing babies...Could the presentation of weighing affect how it is perceived?...We know from studies on other aspects of midwives communication skills that these may not always achieve the desired ends." The review goes on to say that in order to prevent harm associated with breastfeeding problems, protocols for assessment of intake do need to be in place -- this would include a method to provide professionals with "what evidence there is that breastmilk transfer is effective." Magda specifically mentions the desireablity of greater use of stool assessments as markers for adequate feeding. But she also calls for other ways to provide "detail on how to assess that the baby is getting milk...Such an approach might identify cases of severely impaired milk transfer while enabling assistance to be offered to other mother-infant dyads with difficulties." The article concludes by saying that "...weighing requires further exploration and integration into the breastfeeding assessment toolkit." I do not read this as proscribing the use of test weights. Rather it appears to me to acknowledge that we need more research and better protocols to enable us to dependably use all the tools available to us. Direct observation of breastfeeding is the LEAST effective way to document intake. This has been verified in several studies. Most effective (in descending order) are: tagging with "heavy" water, weights on accurate scales, looking and listening to feeding. Due to the expense of the tagging method and the not-that-significant difference in accuracy, weights are favored. Perhaps some of the other researchers will comment, and I'd love it if Magda cares to comment. I surely don't want to misrepresent her. Barbara Wilson-Clay, BS, IBCLC Austin Lactation Associates LactNews Press www.lactnews.com *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html