I should be in bed, but can't resist this thread.  
Many good points are being raised about weighing babies, including the need
for, and potential for abuse of, pre and post feed weighings. 

About baby's position during weighing: the scale I use at work, which is the
same model I see in every health care facility I have ever been in in
Norway, an electronic scale with a switch so you can convert from metric to
weirdo weights in no time flat, has a locking function that works great.  I
put the baby on the scales, normally naked, after having tared it with a
flannel cloth on it so the baby won't be lying on cold plastic.  Then I use
the same bar as I use to tare it, and the scale stops at some weight or
other, and holds the number in the display even after I take the baby off
the scales, so I can write it down at my leisure.  Since I didn't buy the
scale and we just have the one brand here, I don't even know what brand it
is but the BF clinic at Evergreen Hospital in Washington State uses the same
model.  Doesn't matter if baby is flailing or restless, the weight is
accurate.
Of course for baby's comfort prone position may well be better.  

Test weighings are not a tool I use in the first week of life.  I test weigh
when I am trying to find out why a baby who seems to be feeding well by all
my usual clinical markers, is not thriving.  I need to know whether what I
think I observe, is in fact what is happening.  I make a real effort to
communicate to the parents that I am not trying to see whether baby has had
"enough" or whether mother or baby is clever enough at feeding.  I am trying
to reconcile what I see with the evidence from the scale.  There are also
cases where we need to know exactly what a baby is taking in, but I don't
see a lot of babies who fall into that category.

Naked weights, OTOH, are an integral part of a routine post partum follow up
visit.  I think we are remiss if we do not take the trouble to see to it
that babies are thriving.  If they are, no harm done by weighing and if they
aren't it is much better to start fixing things before they get entrenched
and out of hand, and are putting the baby and the breastfeeding in jeopardy.
I am not surprised very often but it does happen, so rather than having it
be a judgment call about whether to weigh a baby, it is a routine part of
virtually every appointment in our clinic.  Besides, if it is a BF
appointment it is a neat way to get the baby in the proper attire for skin
to skin contact.

The problems arise when people whose knowledge about supporting
breastfeeding starts and ends with how to place a naked baby on a scale, get
into the picture.  The weight is ONE piece of information in a complex
picture involving the relationship between the mother and the baby, their
positions in relation to each other, and all other the bits and pieces we
take in globally when watching a mother feed her child.  It is of no help
whatsoever for a mother whose baby is gaining slowly or not at all, to be
told to return in a week for a new weigh-in, and that if the baby hasn't
started gaining better by a week from now, or two weeks from now, she'll
have to supplement, if she is not also offered REAL help to find out what is
happening when she believes her baby is feeding.

Scales are a gadget, like shields, pumps, breastfeeding pillows, nursing
bras, and many other things.  IMO scales are a more essential gadget than
lots of the others, but all of them have their place.  I lament the fact
that it is much easier to introduce a gadget that has no intrinsic value,
than to get the health services' employees to take in the knowledge they
need in order to use the gadget appropriately.

Rachel Myr
Kristiansand, Norway

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