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Date: | Mon, 23 Jul 2007 08:44:42 -0400 |
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Dear all:
No one has yet come up with a convincing and evidence-based reason to NOT use the
scale!
It keeps me in shape so I don't need body sculpting or stair stepping classes.
It is useful for ingratiating myself with my son's teacher at school for class projects (eg.
weighing pets).
It can weigh letters so I don't have to guess the weight for mass mailngs.
I find the information from the scale useful based on the experience I've had with once a
week and now twice a week support groups and clinics. This is where I have tried the
"wait and see" with some lethargic babies and the "assertively nudge" and the
"agressively intervene" approaches with various assorted babies and see the outcomes.
Women come to this group for a few visits, for a few weeks, for a few months and some
even until their infants are 6-9 months old. It gives me an entirely different picture from
one or two home consultations. This is why I don't trust the lethargic baby to really ask
for food --- nor even the marasmic baby --- the ones that are avidly alert and won't eat
--- to cue appropriately. Their mechanism for hunger has been shut off.
Nevertheless, when I think about how test weighing has been used in some countries in
Europe and in Australia, I understand how the obsessive weighing the baby before and
after every feeding can be intrusive and detrimental. I'm not sure anyone has
documented this in a "evidence-based" manner, but I know it exists.
It is akin to the problem in growth monitoring and promotion. Growth monitoring may
become the intervention and everyone forgets it is useless without growth promotion.
Which means actively listening to and working with mothers to help them develop their
own solutions to figuring out how to feed their children with limited resources. The time
and money spent on growth monitoring without promotion would be far better spent on
other interventions to enhance nutrition.
Similarly, I would shudder at the thought of some algorhythm of "if your baby only takes
x ml or g at a feed on such and such a day, you must supplement...." just as I would
with any other indicator taken in isolation. Reductionist thinking does not work on an
indidual level. You must look holistically at what is going on for mother and baby.
But, to abandon the scale in the false belief that it is "imprecise" or "inaccurate" from a
poorly designed study that really looked at neither is not appropriate either. That is NOT
the issue that is important.
Best, Susan
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