Dear Nina and others:

There is a huge body of research in nutritional anthropometry demonstrating the accuracy 
of these scales.  The researchers are actually using the wrong standard.  Long ago, 
nutritionists showed the inaccuracy of measuring by EYEBALL what is in the bottle.  Dr. 
Wight has already written that one of these studies were flawed.  I will be happy to 
demonstrate at the next ILCA conference how poor eyeballing the content of the bottle is.  
There is water tension, the meniscus that can be misread, the breastmilk that clings to 
the bottle and doesn't come out.  All of these things have been researched before and 
need not be researched again.

Nutritionists have done a huge body of research on estimating intake.  The bottom line is 
that there is NO gold standard.  You can do 24 hour food records.  What happens - people 
change what they eat.  You can do 24 hour weighing the food and plate waste.  Again, 
people change what they eat.  You can do 24 hour recalls, people forget what they ate.  
You can also do food frequency recalls.  None of these are the truth.  Each of these has a 
role when you understand what information they do provide, what their flaws are, and 
how to use the information in conjunction with others.

No one except researchers does 24 hour test weighings.  Again, no one who uses test 
weighing uses it in isolation.  Anyone who is guessing by swallows falls prey to the same 
problems of dependability.  If you observe swallows at one feeding it does not mean that 
all feedings are the same as the one that you observed.  Also, I guarantee you that none 
of the mothers I see are stressed out by my use of the scale.  They are usually quite 
relieved.  ANY measure that you use whether clinical, diaper counts, behavior, weights is 
subject to dependability problems if you don't do follow up.

It is not the tool that is the problem, it is the use of the tool.  Any tool, even observations 
of swallows can be misused.  I cannot tell you how many babies have been sent out of 
the hospital when their mothers were told that they were swallowing, only to have that 
not be the case.  Or vice versa.

One of my Australian colleagues here explained to me how her baby was test weighed for 
every feeding when she gave birth in Australia.  That to me would stress a mother out 
entirely.  That is NOT how most people use scale.   I use it like any tool I use in the 
kitchen.  Measuring cups, teaspoons, etc.  Taste always wins out in the end over precise 
measurements.  Judiciously and appropriately and in context.

Best regards, Susan E. Burger, MHS, PhD, IBCLC

             ***********************************************

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