I know this has been discussed ad nauseum, but I really want to second Jan's
post, which sums up pretty much how I feel.  I think most, if not all, of us
would agree that it should not be used routinely or even very often.  But I
don't understand the insistence that it never has a place.  As someone with a
foot in both worlds - the basic approach of understanding and trying to
convey breastfeeding as a natural process and making it as low-tech and
normal as possible that comes from my years as a LLL Leader - and the
experience of working as a nurse and lactation consultant seeing situations
where "just keep baby next to you and nurse more often" is not enough, where
even breast compression and better positioning is not enough and baby is
really not thriving - I don't see why it has to be "either-or".  I think many
who oppose all use of test weighing or any calculations come out of the
experience of seeing it used routinely and negatively.

The way I use weighing, I have NEVER seen a mother react negatively to it.
As I said, I make weighing the baby part of my initial assessment - something
all the mothers I see want.  Parents in our part of the world love to see how
much their babies weigh.  I only do a post-feed weight in a small number of
cases, but I have the baseline if I need it.  As Jan said, these are cases
where we already know there is a problem and in a few cases test weighing
gives useful info.  Moms either already know there is a problem or think
there is and, in some cases, can be reassured by test-weighing that there
isn't, or at least that insufficient milk isn't the problem (and in those
cases, I only do it if my clinical observation of the feeding tells me baby
has taken in a lot)  When it is used in the context of an approach that is
reassuring and supportive, I don't see what the problem is!

By the way, someone stated that they thought it was mainly used by insecure
new LCs.  Actually, my closest LC colleagues and I come from an LLL
background, have been doing this for many years and have fairly recently
added test weighing as a useful tool in appropriate situations.

As with all the numerical data that have been cited - lab tests, fundal
height, etc. - if they are used as one additional piece of data in the whole
clinical picture, why reject them?

                                Miriam Levitt RN, IBCLC, Berkeley, CA

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