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From:
Janet Simpson <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 15 Dec 1996 16:51:09 -0500
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In a message dated 96-12-14 09:56:40 EST, Judy K. writes:

<< : I don't believe that test-weighing proves anything.
 By test-weighing, I mean weighing a baby before nursing and then
 immediately after nursing. Not only is the mother usually under pressure,
 but so is the baby, and these are just two factors which may be highly
 significant. It undermines confidence and "proves" nothing - certainly
 not sufficent to indicate adding formula, solids or stopping
 breastfeeding.  >>

Hi All,
I know that we have been on this track before, but it was quite a while ago,
and since it has been brought up again, I'd like to throw in my .02,
especially since I have about 18 mo more info under my belt on this issue.
I believe that in some cases test weighing can be an incorrect choice for a
specific situation.  BUT, for the moms that we see at our WIC clinic, test
weighing can be a very valuable tool.  Not only for the LC, but also for the
mom.  We have a high standard of care that we provide and a a fairly standard
approach for most cases (though we don't treat them all the same, because
they aren't).  We need to see what baby is doing at breast.  SOme babies look
like they are doing great, but for some reason are losing weight and aren't
having the wet and poopy diapers they need, so we bring mom in with her pump
and her baby, do a weight check before, then mom BF the baby.  While she is
BF, the LC talks to the mom about "whatever" and keeps her relaxed.  Mom is
told that this is just an "idea" of what baby is getting, not an absolute for
every feed.  We have found several babes who looked like they were doing
great, but got maybe 10cc during a 15 minute nursing on one breast.  Mom
pumps the breast and gets 4 oz of milk.  Obviously, baby is doing something
 wrong.  Then the next step is to BF on the other side.  Same thing, baby BF
for 15 min, gets 15 cc.  Mom pumps 3.5 oz.  Then the detective work starts.
 So, if it hadn't been for test weighing, we would not have known that baby
wasn't BF right, and moms supply would be in danger (especially if someone
else told her she obviously didn't have any milk. so she would then quit).
 SO mom pumps and the LC and mom work together to get baby to BF correctly so
that s/he can do the work s/he should be.  We do test weighs because moms
come in and ASK us to do them!  They are getting flack from Dr or family that
baby isn't getting enough (even though baby is growing quite well, with
plenty of wet and poopy diapers).  So they come in for a consult, and go home
with the satisfaction that their baby is getting plenty and that they are
fine, it is the rest of the people who don't have a clue.
If approached the right way, test weighs can be very reassuring for a mom who
has a BF problem or challenge, and NOT undermine moms confidence at all.  We
have had cases where we have discovered that no matter how much mom BF, her
supply is not going up, so a test weigh determines that baby is only getting
1/2 of what s/he needs at breast, and then we instruct mom to "feed the
baby".  We have never told a mom to discontinue BF even if she had NO supply
whatsoever, because we are smart enough to know that BF isn't always for
food, it is also for comfort.  We then offer SNS or p-syringe options if mom
is interested.  If not, then mom BF for her and babys enjoyment.
I agree that to do a good test weighing, baby needs to be weighed before and
after for every feed for a certain amount of time.  That is the only way to
get a truer idea of what baby is really getting over a 24 hr period.  I had
one client buy a scale for this purpose because of milk supply problems with
baby #1.  It turned out that, though she was BF every 1.5-2 hrs, and pumping
after feeds (with no milk coming out) baby was only getting about 1/3 of what
he needed.  So, as a result, she was able to avoid any problems with jaundice
and dehydration in the early days.  She knew to give it a couple of days to
see what happened, and then started supplementing apropriately.
Well, enough rambling.  Just MHO!

Jay
(who would never worry about a test weighing for my child, even tho I know I
will have plenty of milk!)

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