Kellie, you asked about infant weights at the pediatrician's office and use
of diapers. If a baby has "poor weight gain" it's important to know how many
ounces shy of normal gain the baby is, based on the norm of 4-8 oz/week in the
first several months. That the baby stooled would impact weight by perhaps
1-3 oz depending on the amount of stool (I've seen this when weighing during
home visits). One weight that shows inadequate gain, should be followed up with
another weight check in several days, with investigation of infant's feeding
pattern over 24 hr; how long are feeds, how often, amount of swallowing, use of
both breasts or one, etc. If it's in the early weeks, assessment of mom's
milk supply, are her breasts full feeling before a feed and softer following,
and so on, should also be done at time of visit. If there is concern about
infant feeding and or mom's supply, a timely referral to a lactation specialist
who has time to observe a feed, do feeding weight as indicated, and provide
intervention to improve weight gain should be done. Not the unfortunate knee jerk
reaction of starting infant on formula supplementation.You also didn't
mention how old this infant is which would impact the seriousness of weight gain; a
young infant of several weeks could be of more concern than a six month old
whose weight gain has slowed down. All this said, infants should be weighed
naked or in a dry diaper with diaper weight subtracted; the same scale should be
used for subsequent visits. I've gone into so much detail because often
newborns are just limping by with marginal gains due to a breastfeeding problem and
when that problem is not addressed right away it becomes a bigger problem in
a couple more weeks, and suddenly baby's not gaining at all or losing weight
and mom's supply is low. So rather than quibble about stool or no stool,
looking at the whole picture of baby and mother is important and could prevent a
downhill course.
As for your question about feeding weights, a baby is weighed prior to
feeding in whatever clothing or diaper he has on, and a post feed weight is taken
immediately after feed in the exact same clothing and diaper, whether stooling
occured or not. So you are right about removing a soiled diaper for a feeding
weight, it most certainly affects the outcome.
"I have a question about weighing infants. There was a mother at a recent LLL
meeting whose infant had "poor weight gain." She was weighed at the
pediatrician's office. The test weight was without a diaper, and the
infant had a huge bowel movement just before removing the diaper. Had the
infant waited to have a bm after the weight check, he would have been
heavier, right? In a newborn, I would think that the difference would be significant,
as their body weight is so small in the first place.
This puzzles me. I know that diapers weigh different amounts, but would it
not be more accurate to allow the baby to wear the same kind of diaper for
each weight check? The weight of said diaper (dry) could be subtracted
from the infant's body weight at each weight check. Of course, the infant
should not be wearing the diaper for hours before the weight check to "pad"
the weight. If one is doing a test weight to check for milk transfer and the
baby poops while nursing, I would think that removing thediaper and its contents
would skew the results."
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