In response to Pat Young suggesting that pre and post feeding weights are scary for moms, I have to heartily disagree that this is the case when these are used as an appropriate educational and verification tool.  

There have been many tools that I was uncertain or intimidated about using when I was a trainee - such as Haberman bottles, Supplemental Nursing Systems and nipple shields.  You can find individuals who are against using any one of those tools based on experiences when they have been MISused rather than used appropriately.  I've seen many clients who come out of the hospital with 16 mm nipple shields crammed over normal sized nipples with a baby with a perfectly normal sized mouth and the mom was told she had "flat nipples".  By the time I see her, the edema and engorgement have subsized and the nipples look perfectly normal and the baby latches just fine without the shield.  And.... sometimes these cases lead to underfeeding and suppression of the milk supply due to poor milk transfer. I could go on about the misuses of other devices as well. Yet, there are times when each of these tools are very helpful.

I worked for a solid 2 years with no scale and I have to say that I missed babies who were not feeding well (the fakers) and thought some babies were not feeding well (the stealth feeders).  It was a stealth feeder that finally convinced me to buy a scale.  I SWEAR that baby looked like he never moved his mouth.  Just clamped on and went to sleep.  He had been bottle fed for days.  When he unlatched he went into a deep sleep with his mouth clamped shut and the supplemental pumped milk I thought he needed and was going to help his mom feed through a feeding tube was not going to get into him with his mouth sealed shut.  I spent a totally anxious week thinking he was going to starve to death until he came into the group where they had a scale.  He exhibited exactly the same behavior.  Latched on eyes closed mouth not moving and took 5 ounces in 10 minutes.  No noises, no choking, no gulping, no jaw movement.  The most stellar stealth feeder I ever met.    

In my little corner of the world in New York City, the cultures (there are many here) are such that mothers actually feel reassured by the scale and relax because they have an objective measure of their baby's intake.  You can use the numbers to convince them to wean off unnecessary supplementation and to safely and gradually withdraw necessary supplementation.  When a mom has to pump for a baby that has had feeding difficulty it can be very important to see gradual progress and to reassess the interventions when that progress stalls. 

Finally, I think the cumulative effect of having to mop up after other people who miss the early signs of underfeeding is really beginning to get to me. I am tired of seeing babies who are failing to thrive when the mom really did know that something was off and everyone else brushed her off.  I am tired of seeing them at the point when their supplies are in the toilet.  I am tired of seeing how little babies are drinking when everyone else told the mother the baby was swallowing effectively.  I am tired of plotting out the growth charts where the mom was told that the baby was gaining normally or mom is small or a zillion other excuses for not really taking a closer look - until the baby is falling off the growth charts.  It is SOOOOO much easier to catch this early and fix it without having to have the mother and the baby suffer negative consequences.  And, so much of this I can actually predict with a variety of observations that INCLUDES using the scale for pre and postfeeding weight checks early in the process. It is 10 times more stressful for mothers to have to wait until their babies fall off the growth charts to finally get someone to pay attention than to have a timely quick intervention early on.

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