>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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