Since we have scales that are accurate to 0.1 oz and have the time to watch a full feeding and my 
nutrition background included courses in anthropometric measurements and I've spent a lot of 
time training health workers in third world countries - I feel confident in my use of the scale as I 
do in my colleagues at work.  

Having watched lots of measurments in my pediatrician's office (whom I adore for his medical 
advice), including the HemoCue stick test for anemia - I can make lists of the errors in how 
measurements are taken and how they would affect the interpretation of results.  I've seen similar 
errors in other pediatrician's offices.  Measurement error (including systematic bias) is always 
something must consider when multiple observers and multiple instruments are used.  

Watching the baby is a double-edged sword.  Sometimes it not just the possibility that the baby is 
fine despite a weight that doesn't conform to a cutoff, but the opposite.  Right now we have one of 
these cases in our support group.  All the measurements are borderline normal.  The baby looks 
worse and worse despite what appears to be a reasonable intake and a borderline adequate weight 
gain.  I'm trusting my visual observations on this one.  It may not be a breastfeeding issue, but 
this baby is not doing well.  The weight is just one of many useful indicators that I would always 
include in an array of many observations.

Best regards, SUsan

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