Just to clarify several things. 

Here in the UK we distinguish between peer support -- which is very much 
'in' at the moment, as you can see by many published papers in this area 
recently-- and volunteer support.  Heather and I are volunteers, which means 
we underwent a training of several years, have regular supervision and 
on-going training requirements and that we are insured by our respective 
organisations to work with women. 

Peer support means giving women a shorter training to support mainly with 
encouragement and social support and basic good bf info.  These peer 
supporters usually have specified limits on the situations they can give 
information about and will refer on to health professionals or to 
volunteers.  (Some schemes have the capacity for peer supporters to go on to 
train as volunteers.) 

As for test weighing, it is completely true that volunteer breastfeeding 
supporters do not have scales and would therefore not weigh.  However, in 
the UK test weighing has died out and I have not heard of *anyone* 
conducting it in any circumstances in the last two decades (it is possible 
that it is done in SCBU, and I have not heard of it).  Even the health 
visitors in my study, who were happy to conduct routine weighing every week 
on healthy babies (why???) were sure that test weighing has been discredited 
and no one would do it.  One described a paediatrician who mentioned it as 
'out-of-date'. 

Since we have no one who uses it, I suggest that it would be dangerous to 
re-introduce without any training or consensus as to how it is useful.  This 
is one of the major fears I have about the introduction of the IBCLC 
credential into the UK, that those newly-inducted in American cultural 
breastfeeding habits will import alien practices which cause damage because 
they are counter-cultural.  We struggle here with the damaging effects of 
our own UK century-long habits of routine weighing, what we don't need is to 
add to this with sloppily introduced new technologies such as test weighing, 
thanks!  To introduce properly -- if we could do this, we would be talking a 
situation in which we had implemented the Global Strategy with a national 
breastfeeding committee, etc, pie in the sky as far as the UK is concerned, 
I am sad to say. 

During the SOP discussion I was fascinated to see some people describing the 
IBCLC as the bastion of breastfeeding as normal in the USA.  Here, IBCLC 
practice has the potential (I fear) to even more deeply medicalise 
breastfeeding, and test weighing is one example of this.  I do not claim 
that we in the UK are working in a situation where breastfeeding is 
considered normal, but it is clear, after years of reflecting on this, that 
my native USA is even more deeply medicalised.  Ironic, since in the UK we 
are in the place were women congregate weekly in the clinic to weigh their 
babies and decide their on-going feeding on the basis of poorly-interpreted 
plotted weights on a UK reference chart. 

Obviously you will largely disagree with me, because this weighing thing 
clearly touches the roots of our cultural conceptions of what breastfeeding 
 -- and even life -- are about.  In any community there is never going to be 
consensus on this, however, I hope I have clarified how this is DIFFERENT in 
the UK, despite our status as political, cultural and economic satellite of 
the USA. 

Magda Sachs, PhD
Breastfeeding Supporter, The Breastfeeding Network, UK. 

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