Here's what happens in the UK, where we have a good, free, public
health system in the postnatal period which virtually *everyone* uses
(even the very small no. of people who pay out for maternity care,
including the services of our very few privately-working IBCLCs,
will still see community midwives, health visitors and GPs). As a lay
breastfeeding counsellor, I am delighted about that.
When it comes to weighing babies, the community midwives and the HVs
do this, either as part of home visiting and/or well baby clinic
appointments. I don't do it, but I do certainly want to know about
the results of the weighings, if there is any suggestion at all there
might be an issue with the feeding effectiveness or the baby's
health. It is easy for a mother to have her baby weighed, too - she
can just ask for this to be done at the next baby clinic she attends
(in a town or city, she will be able to find a session within the
next day or so).
The frequent complaint among people like me is not that babies are
weighed - weighing is potentially a useful part of any assessment -
but that they are weighed *badly* if I can put it that way.
Here are some situations we encounter:
* inaccurate weighing - I cant always know if scales are accurate or
not in themselves, but certainly the way babies are weighed is
sometimes done badly, with the baby clothed. On other occasions the
weight is recorded inaccurately or mistranslasted from metric to
imperial (here, weights are normally done in metric but people - inc
HCPs - talk imperial, so weights are almost always translated and
mistakes are not infrequent...it's human error)
* repeated weighing when there is clearly a prima facia problem. The
HCP worries about the baby's weight, but does not know what to
do....so weighs the baby frequently as if the weighing itself will
'fix' things. The rationale is, I suppose, so a truly huge plummet in
weight would be spotted and then action (usually a full switch to
formula) could be taken, once everyone has had a real fright
* weighing is carried out without sufficient knowledge of what is
normal, and what can be done to address a non-normal situation. When
mothers bring up the fact their HCPs have said the baby's weight is
causing concern, it hardly ever happens that a feed has been
observed, or anything sensible has been suggested to address the
issue (plenty of non-sensible suggestions....)
* a lack of understanding of the way the charts 'work' and how they
fit into a full assessment
I see many instances where babies are weighed as if there is
something magical in the scales - as if *all* that mattered was what
the scales said, as if they were some sort of oracle.
I am supporting a mother at present whose baby was still not at
birthweight at 3 months - honestly . Yet this baby was weighed
something like 10 times between discharge from hospital and when she
saw me at 3 mths...and no HCP had done anything at all except
reassure the v. worried mother all was well. Incredible.
Heather Welford Neil
NCT bfc, tutor, UK
--
http://www.heatherwelford.co.uk
http://heatherwelford.posterous.com
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