>For instance, I want to read Magda Sachs work because (and she can correct me if my understanding from Lactnet posts is off) I think her work demonstrates a problem with inappropriate use of the scale.  It is not being used in context where women are given sufficiently empowering advice for them to take back the breastfeeding in a way that enables their babies to gain appropriately<

Susan, 

My ethnographic study was of routine weighing in a situation where women 
were breastfeeding and their babies were not necessarily identified as 
having any problem with weight.  In other words, just ordinary UK practice.  
NOT TEST WEIGHING, on which subject I have little to say, as it is not done 
here in the UK. 

Susan says I describe inappropriate weighing, that rather begs the question 
as to what would be appropriate, and I am not sure we really have a good 
idea what would be appropriate, breastfeeding supportive weighing practice 
for the UK. 

In my study, health visitors and mothers had a poor idea of what they were 
doing in conducting and interpreting ROUTINE weights.   One example: they 
were done way too often, sometimes weekly for almost 6 months.  The 
understanding of the growth chart was poor and led to poor feeding 
practices.  A better chart (based on breastfed babies) would not have 
addressed such issues as the idea that it was ideal for the baby to grow 
along the fiftieth centile (for instance).  Some women actually avoided 
weighing their babies, some since it led to unpleasant interference.  In my 
small sample there were three and they each avoided it for different 
reasons. 

Weighing and plotting are only the first two steps in a growth/weight 
monitoring programme – explaining what the plotted weight pattern means to 
parents, devising interventions or referring where needed are further steps, 
both of which are often neglected and are not meshed in with breastfeeding 
support. 

I found ritual theory very helpful to explain the emotional importance 
attached to routine weighing and the weight plotted on the chart.  We don’t 
support women with new motherhood well here in the UK and breastfeeding 
women are even less well supported.  The ritual occasion of weighing the 
baby has deep resonance in this culture, it speaks about offering up the 
baby to be judged in the most culturally approved way:  through science and 
numbers and visual plotting.  This significance is parallel to any actual 
technical use of the weights. I also find it interesting that, historically, 
routine weighing here in Europe was introduced in order to enable doctors to 
calculate their formulas for artificially fed infants.   I traced complaints 
about the impact of weighing babies on breastfeeding women back to the turn 
of the 19th century, when it began. 

To my thinking, using weighing as the ritual to support women through early 
motherhood speaks of the impoverished breastfeeding culture here in the UK, 
and I would hope there could be ways to enrich this.  At the same time, we 
should be making better technical use of weighing, which is currently often 
on a par with reading tea leaves in usefulness in understanding 
breastfeeding or infant health.  However, as a UK professor of child health 
(Davies) remarked in 2000:  weighing is here to stay “it would take an Act 
of Parliament to stop it”, so it would be good to improve practice. 

I don’t see any prospect of using test weighing ethically here in the UK 
until there is a lot better understanding of weight monitoring in order to 
provide a suitable context.  If we were to achieve that, and a deeper 
understanding of breastfeeding (hey was that a pig flying past the window?) 
it might be a useful tool. 

Magda Sachs 

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