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From:
welford heather <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 12 Jul 2013 16:34:32 +0200
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On 12 July 2013 14:56, Susan Burger <[log in to unmask]> wrote:

> Emily complains that she is a little surprised by the reaction to this
> test and compares it to test weighing.  And I'm a bit confused by her
> reference to it being "absurd to use this without other interventions".
>  This "test" is not an intervention.  It is an assessment.
>
> I personally never recommend using any assessment indicator in isolation
> from thorough observation and a thorough history, which she does not
> mention.  I do question a single study being used to define clinical
> practice.
>

<snip>

>
>   I would want to see a serious comparison of other methods of estimating
> "production" with predictive values attached.
>



Me too - and in addition, we would also need some further qualitative
research on what it feels like to be a mother undergoing an assessment like
this, what impact it has on her confidence and her feelings about bf, and
what the longer-term outcomes are.

>
> In the end, however, Jane Kershaw gave what I consider the only reasonable
> use for this particular indicator.  That is showing mothers the difference
> between that very satisfying larger bottle of milk you get when you wait
> longer intervals and the reality that you may get more milk in 24 hours
> even though each pumping will look smaller by pumping more frequently.  I
> personally think there are easier ways to convey that information to women
> who must exclusively pump, but I can imagine it might be useful for some
> mothers.


Yes - surely we can just *tell* mothers this is the case, explaining
carefully and sensitively....it's definitely something mothers find hard to
grasp at times, so in an extreme situation, I suppose you could ask her to
do the 4 hour test to prove things are as you say. But it would have to be
an extreme situation, surely.

Heather Welford Neil
NCT bfc, tutor, UK

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