I wrote:

>>How can hospitals have a lower 'acceptable' level of blood sugars when
>there is no consensus on what constitutes the norm...especiallty when such
>routine interference results in supplementing?<

Magda wrote:
>
>Yeah, Heather, and how can practitioners be intervening on the basis of the
>amount of stooling when the consensus of Lactnet is that there is no
>standard and we don't even have a unit of measurement?

Yes - though as I said to someone who posted me offlist, in the UK babies
at least see a HP routinely several times in the days and weeks after
birth, who will pick up babies who are actually ill (even if the bf
information they get is, er, variable in quaity). So some pointers on
newborn health may be helpful.

I have great difficulty in accepting these pointers need to be as
prescriptive as the discussions, however. We may know - or guess on the
basis of experience and observation - what most healthy newborns are likely
to produce, but that does not give us any idea of the range of normal or
acceptable.

If the hypoglycaemia protocols are unacceptable because we don't know what
the normal range is, then stooling and urine protocols fall at the very
same hurdle, you are right.

> And how can health
>visitors in the UK be harrassing and harrying women because their babies are
>not thriving, when they do not follow adequate practice for
>weighing/monitoring and have no defensible standards (aside from the
>question of whether the standard should be used for the individual).

Absolutely. Harrassing and harrying is right. Weighing routines differ
hugely between practitioners, and it drives me *nuts* that HVs, whose
*basic job* it is to promote health and support healthy practice in
families, cannot recognise when bf is going well, or badly. All some of
them can do is weigh the baby - and even then they get that wrong.

Good HVs - and I know some of them - have a really hard time trying to
practise how they want to, as they end up going against colleagues.

Heather Welford Neil
NCT bfc Newcastke upon Tyne UK

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