I am a PPLC and also run a small store and pump rental station. There is a
pediatrics practice in town who refers many of their patients to me to get
this and that when their nurse practitioner recommends such a thing (this NP
is taking the IBCLC boards this year). Several times I've had moms ask for
"More Milk Plus" or something to get their milk supply up. As I discuss
this with them, I find that there was no ac/pc wts done to determine
transfer... this diagnosis was based on the mother's report of the baby
wanting to nurse all the time. I suggest to the mother that she request
another appt and ask that ac/pc wts be done so that she can tell if there
really is a problem. Another reason I'm given for wanting to increase
supply is that the baby isn't gaining wt fast enough and it is automatically
assumed that is because the mother's supply is not enough. It boggles my
mind that no one is even checking to see if the baby is transferring milk
effectively! Of course they do not want to schedule an appointment with me
as they already have a "lactation consultant" at the peds office. I do plan
on having a discussion with the NP that I mentioned above, I just need to
wait until I can talk to her about it without screaming.
I do caution mothers that test weights aren't the final word, but merely a
piece of data, and that they need to be considered as a snapshot of that
moment in time. But even so they can be a valuable piece of data in
determining what is going on in any given situation. So, I'm with Kathy...
when we are seeing moms with problems regularly, I feel it is very important
to get that crucial bit of data to make a good diagnosis and plan.
Especially in the scenarios mentioned above, I don't see how one can
advocate increasing milk supply without it!
Regards,
Cindi Swisher, RN, IBCLC
-----Original Message-----
From: Lactation Information and Discussion
Sent: Wednesday, May 26, 2004 5:44 PM
Subject: scales
<snip> I personally think test weighing is very very important. It often
"cuts to the chase" on what the problem is and saves much time trying to
assess what is going on. With the right scale, one that measures down to 2
grams accuracy. Now, I don't help "normal" situations, only crisis and
problem situations. And I want to know, really need to know, what intake
baby has had in order to make a care plan. <snip>
Kathy Eng, BSW, IBCLC
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