Dear all: First, I feel that I come from a very different background from most US-based LCs. I have the utmost respect for those of you who deal with babies in the hospital. I could never do it. We each have our niche and I prefer working with the long-term breastfeeding relationship that occurs when a woman is at home (after a delivery there) or after she returns home from the hospital. So, I consider myself nonmedical. As a nutritionist, however, my observations of the use of anthropometric measurements (weights, heights, lengths, head circumference, etc) I have seen in my own and other pediatrician's offices in Manhattan would never past muster in terms of how I learned these techniques for my work in developing countries. I actually think the average health care worker AND mother in Tanzania could do a better job with a hanging scale and their TRIPLE A cycle of Assessment, analysis, action (Don't know what they call it in KiSwahili). So, I do not consider the general medical estabishment here in Manhattan to be the best users of weighing scales. Also, I worked from 1999 to 2004 without a scale watching many babies suck swallow patterns. So, I consider myself quite experienced in watching the natural rhythms of swallow. Nevertheless, I still urge some of you to reconsider the scale on the basis of what I call the stealth feeders and the fakers. I defy anyone to spot these babies in action by watching and listening alone. The faker is the baby that sounds as if s/he were gulping away, big deep jaw drops, vigorous movements. This is the baby often sticks the tongue up to the roof of the mouth and is probably gulping down saliva. I've seen babies that I would have sworn were taking in a good 3 oz only to discover they took minimal amounts or nothing. I usually weigh these babies 2 or 3 times to convince myself that my measurements are accurate. I am sure that some of you will sometimes be able to spot that tongue up, but I don't think anyone is good enough to detect this all the time. The stealth feeder. This one is really ingrained in my head because I saw one of these just before I got my scale. I swear he looked like he was taking nothing. No sounds, slight quick jaw quivers, barely moving and totally lethargic. I was so nervous that I ran downstairs in a duplex apartment to drag up the syringe and tube to try to feed him more. When I got back upstairs he was conked out unwakable. So, I bit my nails for 2-3 days before the mom took him into support group. He was fine. How many of these babies are given unnecessary supplement? The scale enables you to more appropriately assess these types of babies so you are intervening earlier for the faker before this baby fails to thrive and may be subjected to formula that would otherwise have been unnecessary or unecessarily supplementing a stealth feeder. In Manhattan we have the luxury of having a dearth of LCs for the population and a high income population so we can readily cover the cost of our scales. In other areas for the mom that insists on the scale for those of you who don't like to carry one, one could always charge an additional fee for test weighing. I know that pediatricians charge $50 for a test weigh on the Upper East Side of Manhattan. Think about this. Do we consider pediatrician too medicalized for using a stethoscope? Do we expect them to diagnose purely on the basis of what they hear through the stethoscope? The scale is a tool, useful when used appropriately, not useful and sometimes harmful when not used appropriately. Makes me think we should have a session at ILCA on appropriate use of the scale so it won't be such a hot topic anymore. Best regards, Susan Burger *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html