Gonneke writes:

I just  use the weight-lists from the well baby-clinic visits (which is 
used by up to  98% of Dutch moms, I guess, and are pretty accurate mostly) and 
plot them into  the WHO standards. I feel that the weight evolution, the 
picture one might  say, says more (to me at least) than the actual  numbers.


~~~ Gonneke, thanks for including this bit. I find this is also a problem  
locally. Babies who are "doing well" at the 2 week visit, may not have a  
Well Baby visit, until 2 months, then again at 4 months. Some of them are 
doing  well but we have no real arc to look at and snap judgments are made ( oh 
you  need to supplement with formula.) Others were "surfing" but when mom's 
milk  moves to responding to baby's skills ( which were never really 
assessed well),  they do begin to falter and it gets missed. With so few data 
points, the weight  I get makes sure we have a little more evolution information, 
as you said,  rather than just a few numbers. I saw this happen recently 
when a happy,  thriving, developmentally appropriate baby's mom was told he 
was not gaining  well. They had only 2 "recent" data points, the 2 month, then 
the 4 month.  In between baby had undergone lots of PT work for torticollis 
and had become  very distractable. At least the mom did not listened to the 
"you should let him  cry at night til he learns to sleep 10-12 hours" 
lecture she got right before  the weight was checked. ( This lecture is usually 
given at the 2 month visit,  but if not, then the 4 for sure.) Then the 
practitioner back-pedaled  quickly on that advice. When parents are yelled at, 
frightened, or their  concerns and observations disregarded ( I figure that is 
not much of a problem  where you are), the more information we have that is 
reliable, the better the  decisions they can make about what is going on 
and how to negotiate it. Believe  me, I wish this were not the case. Then 
again, perhaps math/science geeks like  me should not lactation consultants. :) 
Perhaps I have a tendency to  "medicalize" how I work based on my PT 
history, where we do chart the #s for  range of motion, muscle strenghth, etc as 
well as look at other functional  portraits of how a person is doing. Or, I am 
just too untrusting of the  observations and instructions given by certain 
local doctors, based on poor  outcomes, that I am "fighting" in "defensive 
mode" with everything I have at my  disposal. I am glad to know this is not a 
universal experience. 
 
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA
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