The situation in my support group last month could have been used as a test
for LCs!

One baby was developmentally healthy (actually ahead, as most of our babies
are! <grin>), alert, awake, etc.  I observed him latch on, nurse, let go
while mom was still dripping milk, and get interested in the other things
happening in the room, crawl away, etc.

Another baby was obviously under-fed - the large brown eyes rarely left
mom's face - he would nurse, nurse, nurse...then let go - then go back again
and again.  He was not developmentally behind, but he was just "normal".
(Of course this behavior is not necessarily due to under-feeding, babies may
feel overwhelmed in group meetings and behave differently in this setting,
but the mom reported this was normal behavior for him.)

Both babies were in the 10th percentile - but one was supposed to be, the
other was not.  The first baby's mom was given the "spiel" I usually give to
moms whose babies are in the 10th percentile - look around the room, there
are 10 moms here, so if you graphed their weights, SOMEONE (I won't say who
- but it actually would have been that mother) would be at the 10th
percentile and SOMEONE would be at the 90th!  (Had I been more diplomatic I
should have chosen height - it would have given the same point without
touching on the emotionally-sensitive weight issue).

The problem with percentiles has become so great that in our breastfeeding
coalition binder we now have a handout that has a graph and clip art babies
in the different percentiles with the explanation that all the babies are
healthy even if in the lower percentiles.  This is used by the WIC staff to
explain percentiles to moms - it's a hard concept to grasp, as we're used to
thinking of 90s as being an "A" and 10s of being an "F"...

HOWEVER - the other baby's mom DID need help - and didn't want to hear this!
I had to be very diplomatic, speak to her at length after the meeting - and
made various suggestions.  Just got a message from her in my answering
machine - milk production is up, as is baby's weight.

LCs, like all other health professionals, need to know their stuff - and be
observant - and know when interventions are appropriate and when they are
not - and know HOW to intervene!

Even if we know there are health care professionals that see babies in our
community who seem to be excessive in wanting babies to gain too fast - we
have to LOOK at each case - because in SOME cases - they may be right!

Jeanette Panchula, BSW, RN, PHN, IBCLC

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