Hi Heather,

I also have seen quite a few babies with less-than-adequate(as presently
defined} stooling, who were fine with weight gain and overall, had no real
problem. But just about all who were having problems with weight gain or
other measures of intake, were also showing less than optimal stooling. It
may not be perfect, but it seems to be a good tool, at least for initial
evaluation, and it is one that parents can use.  There are, of course, many
indicators that LCs should be using, but I would hate for anyone to suddenly
think that pees and poops are of no value, especially if it is someone who
is doing a lot of phone or email counseling and is depending on mother
evaluated indicators.

Sharon Knorr
IBCLC, NY, USA

On Sun, Feb 22, 2009 at 11:39 AM, heather <[log in to unmask]> wrote:

> Dear all:
>>
>> At the San Diego ILCA conference, Laurie Nommson-Rivers did an excellent
>> presentation
>> of the predictive value of pees and poos.  She used receiver operating
>> characteristic
>> curves (which are a great way to assess cutoff values).  Her work really
>> shows that the
>> predictive value of what goes into the diaper is poor and they should only
>> be used as a
>> rough guide ALONG WITH OTHER INDICATORS.
>>
>
>
> I think we'd probably all agree....the beauty of pees and poos is that they
> are a useful and easy to monitor rough guide which *any* mother can be
> taught to look for, and which *any* mother will be able to answer, when her
> HCP discusses the baby's feeding with her.  Too often,  at least here in the
> UK, the question the mother gets asked is 'how's the feeding going?' and
> that's it. End of discussion. The mother can say 'fine' and her criteria for
> judging this could be way off.  But asking about elimination is a good
> starting point which has an answer which does not require a judgement.
>
>
>> I have seen many a baby who is in serious trouble with perfectly fine
>> diaper counts and
>> many a baby who has diaper counts that would suggest trouble who are
>> actually doing
>> well in the intake department.
>>
>
>
> The babies I have seen in serious trouble *with HD * have all (I think,
> all, anyway) have none of them had what you would call 'perfectly fine'
> counts, though....but I'm interested to learn if this is not general
> experience.  But I have seen many with poor or even absent stools or
> persistent medonium stools who have been ok...though it is always good
> practice to encourage freq, effective feeding anyway, and to ensure all the
> other indicators are ok (or are on the way to becoming ok).
>
> Heather Welford Neil
> NCT bfc, tutor, UK
>
>
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