carol says,
<< there are LCs (in my area) who believe it is necessary to do a test weigh
 (before and after nursing) of EVERY mom/baby dyad they see. they honestly
 can't tell if the baby is transferring milk, or perhaps they believe that
 reduced intake is a factor in every single problem they see or i don't know
 what, but i have been criticized for believing that test weighing is an
 invasive procedure and should be used when needed. >>

I do an ac/pc weight with almost all of my consults in my private practice,
or those that come to me w/ problems.  I never call it a test weigh, and I
always talk about seeing how the baby does, not the mom.  Most of my problems
that I see are r/t low or slow weight gain -- plus the sprinkling of thrush
here and there.  But I do want to point out that I've been fooled more than
once by "hearing swallows" and SEEING long, drawing, nutritive suckling, only
to have a baby very unhappy at the end of the feed -- and to check the weight
and find out he took a whole lot less than I thought he did.  And this
finding does change my recommendations from -- 'oh, he's transferring lots of
milk -- just hear him gulping and look at those long drawing swallows' to one
that might be more interventive if we are on day 7 and baby transfers only 9
or 10 mls and is still losing weight.

In my 15 years of practice w/ a busy pediatric group and a private practice,
I've been fooled by the swallow sounds and nutritive looking suck more times
than I care to think about.  So -- perhaps I'm old and don't hear well out of
one eye, and can't see out of the other -- but I do use ac/pc weights when
warranted.  Perhaps it's because of the way I word it, but the moms I work
with are happy to do it, and don't view it as a "test" they have to pass.

Jan -- feeling quite scaly at the moment.

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