Pat-in-SNJ says, << Actually I haven't ever test weighed pre-post feeds (well just once on the hospital's new scale - I was really curious to see if it worked). But back to my comment- I depend on output evaluation, general appearance. I also have a sneaky feeling that some of those who are dependent on scales may be newer LCs. Those of us who have looked at hundreds and thousands of babies have a "sixth sense" about the baby who doesn't look quite "right." >> I have to "weigh in" here again at least briefly. I see moms in the hospital on rounds for the (most wonderful) Pediatric group for whom I am an LC. I would never suggest pre-post weights in the hospital, or before the milk is in and well established. Those mother/infant dyads on whom I DO inflict pre and post weights are those that come to me WITH A PROBLEM. So, in one way or another, it has already been determined that the baby isn't doing well. I use the pre-post weights for those infants who are way below where they "should" be at whatever point they "should" be at. And to Heather -- whom I see erupting out of her chair even as I speak -- keep in mind the context in which we work in the U.S. Regardless of "who" or "what" determined "how much" babies "should" weigh and at "what" point in their lives, and "how much" supplement they should get -- we have to live with that. If a baby isn't gaining appropriately, the alternative is for the primary health care provider to say, "Your baby isn't gaining. Give the baby 2 ounces of formula after every breastfeed." Or worse, "Your baby isn't gaining. You obviously don't have enough breastmilk. Give it up." Or another scenario, "Your baby is obviously not getting enough. You better pump and see how much you are making, and if you can't pump at least XXX number of ounces, then you better give formula." (or a variation on these themes). It makes a lot more sense for me to approach in it the way I do -- sometimes we can determine if it is the mom who has plenty, but baby isn't transferring the milk (I have a couple of those right now who are faced with what seems to be the problem of the week: oro-nippular disproportion (to rephrase Jean's wonderful 'diagnosis.'), or the mom's milk supply is low. If a baby, in my office, transfers only 21 ml on day 8 or whatever, AND this is coupled with scant wet and poopy diapers, and low or no weight gain, I'm pretty certain that he's not going to be transferring much more than that even if he does eat an hour later. And no, it doesn't give me information about caloric intake, and it does only give me information about that feeding, and not the one later in the evening or earlier in the morning, but coupled with everything else, I know this baby isn't getting enough. And IF the mom pumps for me after the feed, and she seems to pump a lot of residual, then I have a gut feeling that probably the baby isn't transferring all there is to be transferred. But if mom can't pump much of anything, perhaps there is low milk supply as well, and the mother and I can develop a plan of care that meets the baby's needs as well as hers. I'm not sure if what happened was that we moved from using ac/pc weights in problematic cases to the assumption we all use them all the time. (I think Carol said that the LCs in her area use them all the time -- but she didn't clarify as to whether or not they are seeing problems or are routinely using them with all mothers). I see an average of 25-30 new moms a month for our peds group (it would be more, but I travel and am speaking a lot, so am not always there). I would guess that out of that 25-30, I will see an average of 2-4/month back in the office for problems. Of those, perhaps 1 is a low/slow weight gain, and the rest are a variety of other problems. Jan B -- who saw 28 new moms in the last 2 weeks, and had 6 back in the office for problems!! *********************************************** 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