The IBLCE Clinical Competencies describe 75 or so activities in which the IBCLC is able to engage. http://www.iblce.org/upload/downloads/ClinicalCompetencies.pdf. Right there, page 2, it says: "3. The IBCLC has the duty to provide competent services for mothers and families and will perform a comprehensive maternal, child and feeding assessment related to lactation, such as ... Skills to Assist Breastfeeding Dyad ... assess effective milk transfer [and] assess for adequate milk intake of the child The part that drives *me* nuts, as a parser of legal language, is that the loaded term "duty" is used throughout the document. So ... if I have a *duty* as an allied healthcare provider to "do" something, and I fail to do it, is that misfeasance? But that is for another soapbox, on another day .... I do not think of test-weighing (as in: Weigh the baby before, and after, a feed-at-breast, using a scale sensitive to 1/10 ounce, without changing diapers, clothes, etc.) as an "intervention;" I think of it as "asssessment." There are many means of competently assessing milk transfer and intake. Test weighing is one of them. It tends to be a regular part of assessment in some countries, and not-so-much in others. When I wear my private practitioner hat in the USA, I do a test weigh each and every time I have a consult with a dyad ... because I usually see them in the two-week time frame after hospital discharge, and after the expected milk surge of Lactogenesis II has occured. Of course, it is just one feed I am getting a snapshot of, but the baby's outward behaviors have fooled me enough times that I like to have the data from the weight as well. When I wear my per diem IBCLC in a large hospital hat, I almost never do test weights on babies. I see dyads in the first two days of life, when colostrum levels are appropriately low. There is so much sturm-und-drang right now, in hospital-based practice, about "weight loss" (versus fluid diuresis ...) in the first few days that I would be loathe to make test weights a standard practice for otherwise well-feeding happy newborns. It has, however, been a useful technique in the hospital when other HCPs are wanting to supplement with formula for whatever reason ... and the IBCLC is wanting to show that the baby *is* getting colostrum. But poor freaked-out mom is the one caught in the middle here, as a respected HCP proverbially stands on one side of the bed imputing "There is not enough milk!" and the respected IBCLC is on the other, saying "Yes there is!" I don't think these "weight wars" do a stinkin' thing to enhance maternal self-efficacy. -- Liz Brooks JD IBCLC FILCA ILCA President (2012-14) Wyndmoor, PA, USA Twitter: @LizBrooksIBCLC FB: www.facebook.com/LizBrooksIBCLC *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome