Subject: | |
From: | |
Reply To: | |
Date: | Sun, 19 Nov 2006 14:14:48 -0500 |
Content-Type: | text/plain |
Parts/Attachments: |
|
|
Dear Karleen:
I beg to differ with your characterization of those of us who have the misfortune to work
with populations that have had a huge disruption in normal infant feeding practices. I
have not seen one single posting that suggests that any of us who do use a scale think
that scale use makes the difference between a lay counselor and a "professional". If you
have seen such a posting, please point me in that direction because I did not read it and
may have missed it. I personally, have pointed out how there are similarities between
any indicator of intake that one would use when one looks at that indicator in isolation.
Never have I personally suggested that the scale is useful for all situations. Moreover, I
think one needs to understand that different tools are often more appropriate for one
situation or another. As I posted before, the work in Tanzania by the Tanzanians and the
Swedes showed how use of a scale for "weighing" not test weighing was an empowering
experience for ILLITERATE women. Another study by one of my dear very outspoken and
sometimes extremely annoying colleague Sabu George showed the total futility of how
weighing was used for supplementation programs in India. The difference in these
findings is the "context of use". I think the study in Tanzania is instructive not because of
the use of the scale, but HOW they used the information to empower these women in
making their own decisions. They could have used any tool --- the point is HOW they
helped these women with informed decision-making. In any clinical setting, we should do
this.
On the other hand, I have seen repeated suggestions on Lactnet that the scale is
HARMFUL. With no proof whatsoever that this is the case in the United States. Before
you judge how some of us use the scale, I invite you to come and observe the challenges
we face and how we use the scale.
I have also seen many many posts of situations from many solid lactation consultants
that show how they have put the scale to good use for encouraging mothers to get away
from worrying about their baby's intake. In the United States setting I find that is helpful.
More importantly, I find it exceedingly patronizing to consider a "lay peer counselor" as
something less in value than a professional. The roles are "different" and that is where I
found the term "second level credential" to be absurd. The roles of a peer counselor
should be considered every bit as valuable and very different from the role of a lactation
consultant. Both should be considered members of the same team and should be valued
for their different and complementary roles.
Personally, I think lay counselors should understand the use and misuse of scales so that
they know when it would be and when it would not be appropriate to refer to lactation
consultants who do and do not use them. I would definitely want peer counselors to know
the difference between a lactation consultant that clung to the numbers on the scale
rather than have the dianostic ability to know how to help mothers with slow gaining or
failure to thrive babies. It is the diagnostic ability that is key. Not the "scale use or not"
that is important.
Best regards, Susan
PS. Heather has been so persistant that she is nudging me into looking into all the
unanswered questions about scale use or not. There are many unanswered questions.
So, I'm starting a series of small studies in my support groups. If I can answer her
questions and get it published --- guess who will be acknowledged in any papers I write.
Only my seven year old son is more persistant than Heather when asking questions and
believe it or not, I consider that a complement even though it sometimes makes me feel
a bit grumpy.
I think it IS important to really look into the issue in a much more profound way than the
fatally flawed study published in the Archives of Diseases of Childhood.
Unfortunately, any study that I do will be relevant only in the context of a society that
has had a break in normal infant feeding practices and high intervention births.
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html
|
|
|