I, for one, find using the gram scale for the occasional test weight to be very 
helpful in many ways. While I make sure that each time I use it, I remind the 
mother (or the doctor) that while this is only for this one specific feed, at 
least we have an idea about the amount of milk that the baby is transferring. 
If it is a worried mom, it usually assuages her fear that she isn't "feeding her 
baby." If it is a skeptical doc, an adequate milk transfer gets the doctor off 
the mother's back and the mother and baby get a chance to do what they 
should be doing without unnecessary interventions. Of course, it also gives me 
a place to start when I have a mother and baby with breastfeeding 
difficulties. There have been times when I have done a test weight (expecting 
to see adequate transfer) and I have found that I was wrong. At least it gives 
me an indication that I need to continue to be concerned and need to work 
more with the dyad. 

There are many times in this field that we can (and should) work with our gut 
feeling. Everything cannot be evidence based all the time. Sometimes, I think 
we use this idea as a shield to hide behind.

Betsy Riedel RNC, IBCLC
Connecticut

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