I will directly address Nina's question.
A resurgence in discussion of test weighing cropped up about 9 months ago because of an
article that claimed that test weighing was imprecise, but accurate. The discussion,
however, misinterpreted this article (myself included) about the "accuracy" of the scale.
It turns out that the authors themselves, didn't test precision because they merely
compared single measurements against each other. This is not testing precision.
So some people who use a scale are under the misperception that the scale is imprecise.
There is a whole body of research that shows that this is not the case. I just went
through many of the questions on lactnet that came up about the precision of the scale.
And I am getting the same results as most of the rest of the studies.
Much of the discussion about scales centered on the precision and accuracy, when I think
it should have been more about whether and how we use the scale and what it really tells
us.
And personally, I don't think you need much accuracy or precision to judge a baby's
feeding. You need to look at the whole picture. One piece that is helpful is to know
whether or not a baby is a faker or a stealth feeder.
The faker looks and sounds like he or she is gulping down lots of milk, but doesn't touch a
drop. These babies can get into trouble quickly. And I defy anyone but perhaps Cathy
Genna with her stethoscope to be able to spot this babies routinely. I do not have the
skills after watching babies since 1999, but perhaps Cathy who has probably been doing
this since before IBCLCs existed does.
The stealth feeder looks and sounds like he or she is just snoozing at the breast. My
worst stealth feeder was a little guy whose mom went to the hospital because he spat up
her blood because her nipples were so cracked. He hadn't been on the breast in about 5
days when I saw him. I would have SWORN that he was not taking a drop. I didn't have
a scale at the time. I drug out a tube to put on her breast, but he wasn't having any
more. I fretted for a whole week about whether or not he was going to get into trouble
and left mom with a plan to offer supplement after every feeding. Had I had a scale I
would have relaxed and never worried about that baby and the mom wouldn't have been
tormenting her baby with useless offerings of supplement. When he came into the clinic
he stealthily downed 4 ounces. I wish I had a videotape of him because, again, I would
defy most IBCLCs to detect that he was really drinking as much as he was.
And finally --- the case that has probably scarred me forever, is the one when the baby
was drinking really well from the breast, but losing weight. Her mother, who later could
pump 35 ounces by only pumping 2x/day, was told she had a low milk supply. I wrote a
detailed report to the pediatrician because this baby could not feed from a bottle, but fed
excellently from the breast. The doctor dismissed this and wanted the mom to pump and
give milk to the baby in a bottle (which took 2 hours to feed her less than she took from
the breast). Then, the baby was admitted to the hospital where she was fed formula until
mom's milk was "proven" safe. The baby threw it all up for about 6 hours. Finally, the
mom got to the endocrinologist who actually listened to her. It turns out that the baby
had a rare genetic anomaly that was immediately fixed by supplementing her with
sodium. She no longer needs the sodium and is thriving.
So, I would put ---- preventing health care practitioners from unnecessarily making a
baby drink from a bottle on my list. This is common practice where I live.
Mainly--- I see the scale as a tool to prevent unnecessary supplementation in the
Manhattan environment where every "New York minute" counts and everyone watches
clocks.
And I'm sure you have read all the other eloquent posts on other reasons why people use
scales.
Best, Susan
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