Hi, I work as a lactation consultant in a pediatric clinic and was
handed this article today by one of our pediatricians.  It comes from a
weekly pediatric commentary called:  Pediatric Notes, October 5, 2006;

Volume 30, number 40.

 

     How Accurate and How Precise is the Procedure of Test Weighing Newborns
to Assess Milk Intake?

  

    " Test weighing infants before and after a feeding is commonly used for
assessing milk intake, both in hospital and at home.  It is assumed that the
increase in the baby's weight (in grams) after feeding reflects the amount
of milk (in ml) consumed by the infant.  This assumption is based on studies
in bottle-fed infants.  The authors of this study (Princess Amalia
Children's Clinic, Zwolle, The Netherlands) point out that a good
correlation between such weight changes and intake guarantees neither
accuracy nor precision.  (accuracy is defined as the ability of a
measurement technique to measure the true value; whereas precision relates
to the spread of results with repeated measurements)  Ninety-four infants
were studied.  They were fed by nurses who were unaware of the measured
weights; and all weighing was done by the same investigator who was unaware
of the baby's milk intake.  The mean difference between weight change and
actual milk intake was 1.3 ml, indicating good accuracy. (emphasis mine)
However, the precision of test weighing was poor:  95% of differences
between weight change and actual milk intake ranged from -12.4 to 15 ml,
with a maximum difference of 30 ml.  The investigators conclude that test
weighing is an unreliable method for assessing milk intake in young infants.
They recommend that the method not be used in clinical practice, and
conclude that there is no reliable, simple and clinically useful method for
assessing milk intake in breast fed infants. 

     (Savenije, OEM, Brand, PLP, Arch. Dis. Child Fetal Neonatal Ed.
91:F330-F332,September, 2006)

 

    Then the author adds a comment:  Abandoning this common practice should
free up considerable nursing time for more fruitful and reliable pursuits.
Maybe we will have to settle for the contented look on the face of the baby,
and resort to weighing only once a week.  (R. Goldbloom) "

 

 

    I told the pedi that we have never said that the test weights were
precise, but they should be fairly accurate - as this study indicated.  I
laughed at the thought of assessing how the feeding is going simply by the
contented look on the babies face!  How many of us have seen the peaceful,
contented look on the baby who is not gaining well!  

    Anyway, I wait to hear your thoughts!

 

Linda Hill RN, IBCLC

Capital Pediatric Group

Austin,TX


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