Liz said:

>I agree, Jan: for a full-termer who is transferring mostly appropriate
>amounts, those tenths of ounces are irrelevant.  But I take comfort in
>being able to give the mother full and accurate information upon which she
>can make an informed decision.  Finding out on Day 5 or 8 or 10 that this
>baby just AIN'T transferring is an alarming piece of news for the mom who
>hoped I had some magic wand in that black bag.
>
>Now -- please -- I am not trying to re-open the debate here of
>should-we-or-shouldn't-we use scales.  It is standard practice in some
>parts of the world, and not in others.  For me, and in my area, it is
>standard practice -- and I personally prefer to have the information down
>to that tenth of an ounce.

I'm with Liz on this one. In my usual setting (WIC in Miami) we use scales accurate to 2gm and I appreciate that level of accuracy. 

That said, for most cases probably 5gm would suffice. There are, however, those cases where that extra level of precision is useful, and the thing is that you don't necessarily know in advance which cases those are going to be. Some babies (and some breasts) surprise you, not to mention that on any given day in a WIC clinic, I have no idea what kinds of cases are going to walk in the door - recently-discharged premies just beginning to go to breast, breast reductions, etc.  The other consideration for me is that I deal with a lot of perceived milk insufficiency, and often that very accurate reading does wonders for a mom's confidence. As one client said to me years ago, "I will never doubt my milk supply again!"

But if the scale shows a pre-feed/post-feed difference of 40ml, I don't want to have to tell her that it could have been 35 or 45. And I wouldn't bother with one that is only accurate to half an ounce.

For my private cases I recently acquired a 5gm scale; it is more affordable, and I have turned down some private cases over the years for lack of a good scale. Time will tell whether I have been thoroughly spoiled by the 2-gram ones....

Regina Maria Roig-Romero, BS IBCLC
Miami FL

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