Dear all:

One of the questions I always ask and is easy to ask in Manhattan is about depression or 
anxiety --- and I stipulate "clinical" because if you asked that question without "clinical" I 
think you'd get a huge number saying yes.  Often jokes are made about "situational" and 
"clinical".  I see many moms who went through depression or anxiety after 9/11.  And 
"therapy" is considered something one undergoes merely living here.  So, its easy to 
mention therapy here.  

So, I've worked with many an obsessive compulsive mom with their charts.  I try to 
divert the charting away from weights and definitely away from diapers and get them to 
start observing behavior and swallows.  After Laurie Nomson-Rivers (I know I'm leaving 
out a consonant in her name somewhere) beautiful presentation with ROC curves on 
diapers --- she concluded that you cannot rely on diapers alone to tell you much about 
the baby's intake.  They do not have great predictive value.  

Behavior and swallows are much closer to the action of "intake".  Swallows are 
immediate and behavior is a response to how much swallowing went on.  I often redirect 
mothers this way to get them to start "programming" them into initially using their 
"analytic" skills and transferring these skills into "triggering" their observational intuitive 
skills.  If they repetitively watch their babies behavior and swallowing and reduce 
tracking the "number" of diapers or "weight" of their babies --- you are effectively 
changing their behavior into what the baby will need more.

Best, Susan

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