Kellie, you asked about infant weights at the pediatrician's office and use 
of diapers.  If a baby has "poor weight gain" it's important to know how many 
ounces shy of normal gain the baby is, based on the norm of 4-8 oz/week in the 
first several months.  That the baby stooled would impact weight by perhaps 
1-3 oz depending on the amount of stool (I've seen this when weighing during 
home visits).  One weight that shows inadequate gain, should be followed up with 
another weight check in several days, with investigation of infant's feeding 
pattern over 24 hr; how long are feeds, how often, amount of swallowing, use of 
both breasts or one, etc.  If it's in the early weeks, assessment of mom's 
milk supply, are her breasts full feeling before a feed and softer following, 
and so on, should also be done at time of visit.  If there is concern about 
infant feeding and or mom's supply, a timely referral to a lactation specialist 
who has time to observe a feed, do feeding weight as indicated, and provide 
intervention to improve weight gain should be done.  Not the unfortunate knee jerk 
reaction of starting infant on formula supplementation.You also didn't 
mention how old this infant is which would impact the seriousness of weight gain; a 
young infant of several weeks could be of more concern than a six month old 
whose weight gain has slowed down.  All this said, infants should be weighed 
naked or in a dry diaper with diaper weight subtracted; the same scale should be 
used for subsequent visits.  I've gone into so much detail because often 
newborns are just limping by with marginal gains due to a breastfeeding problem and 
when that problem is not addressed right away it becomes a bigger problem in 
a couple more weeks, and suddenly baby's not gaining at all or losing weight 
and mom's supply is low.  So rather than quibble about stool or no stool, 
looking at the whole picture of baby and mother is important and could prevent a 
downhill course.  

As for your question about feeding weights, a baby is weighed prior to 
feeding in whatever clothing or diaper he has on, and a post feed weight is taken 
immediately after feed in the exact same clothing and diaper, whether stooling 
occured or not.  So you are right about removing a soiled diaper for a feeding 
weight, it most certainly affects the outcome.

"I have a question about weighing infants. There was a mother at a recent LLL 
meeting whose infant had "poor weight gain." She was weighed at the
pediatrician's office. The test weight was without a diaper, and the
infant had a huge bowel movement just before removing the diaper. Had the
infant waited to have a bm after the weight check, he would have been 
heavier, right? In a newborn, I would think that the difference would be significant, 
as their body weight is so small in the first place.

This puzzles me. I know that diapers weigh different amounts, but would it
not be more accurate to allow the baby to wear the same kind of diaper for
each weight check? The weight of said diaper (dry) could be subtracted
from the infant's body weight at each weight check. Of course, the infant
should not be wearing the diaper for hours before the weight check to "pad" 
the weight. If one is doing a test weight to check for milk transfer and the 
baby poops while nursing, I would think that removing thediaper and its contents 
would skew the results."






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