Liz writes: I do not think of test-weighing (as in: Weigh the baby before, and after, a feed-at-breast, using a scale sensitive to 1/10 ounce, without changing diapers, clothes, etc.) as an "intervention;" I think of it as "asssessment." There are many means of competently assessing milk transfer and intake. Test weighing is one of them. It tends to be a regular part of assessment in some countries, and not-so-much in others. When I wear my private practitioner hat in the USA, I do a test weigh each and every time I have a consult with a dyad ... because I usually see them in the two-week time frame after hospital discharge, and after the expected milk surge of Lactogenesis II has occured. Of course, it is just one feed I am getting a snapshot of, but the baby's outward behaviors have fooled me enough times that I like to have the data from the weight as well. ~~~ I chime in here to agree and expand. I've seen many babies who appear to be swallowing, or are gulping and stressed, but their milk transfer is not normal, even poor, or almost nil. They may have limited tongue movement/power due to restriction, recent release and/or tight or asymmetric muscle function, larnygomalacia, low stamina of early-baby issues. I've also met some "stealth swallowers" who don't seem to have much rhythm or aren't awake yet are moving milk well, or at least much better than it appears. I've seen babies making a wet sort of noise and I pointed out that that was the sound of the baby trying to get the tongue to do what it needed to do, and losing suction over and over, mom said everyone had told her that was the sound of the baby swallowing really well. A test weight showing 0.3 helped the mom understand ( with my framing) how much her baby was willing to work, how breastfeeding was important and they have a nice relationship going, but also why the baby wasn't gaining( at 3 weeks of age already), why "feedings" took up to 3 hours, and help us come up with a plan for feedings that helped the baby get a reasonable amount of food in a reasonable amount of time, etc. This gives the mom and I the information to help her plan, even though it went against the pediatrician, other HCPs, community support suggestions, etc to "just take away the supplement and make her breastfeed more." Test weight, if it can work, can also show a mom how much or little a baby is losing around feedings, either at mouth corners from poor seal, or when refluxing afterwards. A mom can see why her little baby "drinks" a 3 1/2 oz bottle, when 1/3 of it actually caught in the cloth over the baby's chest and that she is not overfeeding ( doctor said mom was overfeeding the baby...) or that that "huge" reflux episode actually amounted to 0.2 oz, not the "whole feed." So, as one part of a very thorough assessment and information-clarifying sharing time, the scale can be very helpful. There are local IBCLCs who still rarely use a scale, but I like the information it provides, part of a very big picture, and often showing us things we couldn't see clearly any other way. I admit this may be a very US-centric viewpoint. Then again I am a nerd and like both the tight focus and the big picture... :) Peace, Judy Judy LeVan Fram, PT, IBCLC, LLLL Brooklyn, NY, USA [log in to unmask] *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome