>  but any tool can
>be used for good or evil


I totally agree, Jane. A tool in situation A can be helpful, and the 
same tool in situation B can be harmful.

But any tool has to be reliable - and the creamatocrit, as we have 
seen, *is not and cannot ever be* , a reliable assessor of the fat in 
a mother's milk over more than the moment in time she produced that 
sample.

In addition, measuring the fat (apart from the purpose of separating 
it, in lactoengineering for tiny prems) is irrelevant. We do not need 
to assess the fat content.  In fact, if we try to, in order to prove 
something irrelevant, we risk it backfiring.

So if it's not reliable, and not relevant, it's a tool that leads to 
a meaningless intervention.

Seems to me this is expensive in staff time, and has the potential to 
undermine a mother's confidence and misleads both her and the HCPs 
caring for her.

We might as well measure the circumference of a mother's areolae - 
actually, at least this could be done accurately as the size of the 
areola doesn't change minute by minute :)

I do sympathise with you having to prove stuff to paeds. Ack!

  But wouldn't it be better, if paediatricians have to have something 
proved, to use the time to share some relevant and recent research 
with them?  Showing them even a 'good' result from a creamatocrit 
confirms them in their belief that quality of milk is something 
unreliable and fragile, and that it should be compared to the 
standard (ie ABM.).

Heather Welford Neil
NCT bfc, tutor, UK

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