Dear all:

I have to respectfully disagree that weighing is NOT a clinical intervention -- and I would argue that it is not an intervention at all.  Furthermore, weighin g -- for the purposes of evaluating growth -- is is NOT a good screening tool either.  The reason why is it not a good screening tool is that by the time the baby is not gaining well, the damage has already been done.  Other screening tools such as the infants behavior and intake are much more PROXIMAL indicators of the baby's feeding than weighing.  Having looked at the evidence -- or lack thereof --- on growth monitoring, I was unable to find any evidence that it makes a good screening tool.  

I was, however, able to find evidence that it makes a good EDUCATIONAL tool, when used appropriately, and can be a draw for mothers to seek other health services.  In this regard, the importance is to collect lots of information about the feeding patterns, illnesses, sleep patterns, etc was well as a good physical assessment of the mother and the baby while feeding in order to figure out a) if a slowing or stagnation in growth is having an impact on health and b) what are the root causes of that slowing of growth.  Usually an in-depth dialogue with the mother will reveal the root causes and enable the mom to develop a plan to improve the feeding.  Linking changes in behavior with the growth patterns can be helpful when a mother realizes --- Oh, when I started sleep training here, my baby slowed down in growth --- Oh, when my pediatrician said my baby should only feed four times a day (a recent case of mine) my baby really lost weight --- and then modify those behaviors accordingly.  When weighing is used inappropriately as so aptly described by Magda Sach's work, it can have negative effects.

The reason why it is not a CLINICAL tool is because everyone rightfully has the ability to buy their own (however inaccurate) and weigh themselves, their baby, their food or whatever as they choose.  You don't need to (nor would I ever want this to happen) have a license to buy a scale or be a health care practitioner to buy a scale.  Parents buy them all the time.  

Best regards, Susan Burger, MHS, PhD, IBCLC

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