It's hard to explain all the thoughts I have on this, but OK, I'll post. I do use a scale in certain situations. The first thing I do, when a mother/baby comes in to see me, is to just look at the baby. Really, I can tell almost immediately how baby is doing by that first look, in most cases. Some look robust and chubby, some look "sallow" and washed out. Premies are a different story, because they can look skinny for awhile. (By the way, virtually all come strapped in their carseat. You have to factor in the culture of your region; more on this later). 
Then mother and I talk. How are things going? How's the milk supply coming in? Baby's behavior, pees and poops (sometimes you really have to dig here) asking specifically about heaviness of diapers and color of pee (reddish color fairly often reported). Remember I am seeing these families about 3 to 5 days old. If  things are going well, then you just reassure and we do a naked weight on the baby. The attending pediatrician asks me to do a set of vital signs and I do a fairly quick physical exam, auscultating etc. (Yes, this is the medical model), checking the circumcision, cord area etc. 
Now, if the baby is not looking good, the breasts seem too soft, the output is low or questionable, and other "red flags" (all clinical judgements based on about 24 yrs experience and taking into account how many days postpartum), I would like to observe a feeding and I'll do a pre/post weight. Virtually in all cases, the baby's milk intake is low like 6ml or 12 ml. We are using best latch and breast compression. Sometimes the baby's milk intake is what I would call "borderline." Not low but not completely reassuring. These borderlines I will likely have mother feed more often, breast compression, and re-weigh. This depends on just how much baby has lost. If it's early in the game, like day 3, mom's supply is likely to increase so we can buy some more time. 
The scale is a tool that helps me decide how much/how often to supplement these babies or just bf more often, for example. I am very mathematical and I admit this is probably from my NICU background. But I do find it gives me a general idea if a small baby needs about 37 ml every 3 hours, then if he's taking 6 ml every 3 hours this is not going to work. I can show the mom that he can take less if he eats more often, like every 1 to 1.5 hours. I have DEFINITELY found that giving parents a fairly precise volume of how much to supplement works well for the ones that need it. If not, I find mothers just don't realize the baby needs more volume, and he continues to lose.
Now here is where the culture comes in (southeast USA - Louisiana and Mississippi). These babies will not be seen again for about 10 days. Some certainly come back to me but many live far away and transportation is a problem. 
These mothers already have a mindset of feeding every 3 hours or so, in hospital the first day or so, it's ok to feed every 3 or 4 hours per nursery and doctors. Some doctors still tell mothers that baby gets everything in the first 5 minutes. Most doctors are not believing it wise to feed every hour, feeling this is just not realistic. Their experience and mindset is really still a formula feeding prejudice. "Kangaroo mothering" is rare. Many of these infants are NICU grads and "near term infants" around 36 to 37 weeks. Some mothers followup at local health departments, where I have found the breastfeeding care is not always great, and where babies are weighed clothed. (One mom was told her baby was back to birthweight when in fact he had lost 5 more ounces since discharge.  If  I could see these dyads daily (I'm the only LC and I work 3 days/week) and if I believed they would kangaroo them and feed them very often, we wouldn't need the scale, just feed them alot, improve the milk transfer, improve the supply if needed, follow them closely and we're good to go. 
I know this is long, I hope it explains something about scale use, although I realize it went off a bit.

Laurie Wheeler, IBCLC, MN, RN
Mississippi, s.e. USA

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