Nina again asks about test weighing from a single feeding given Harmann's research.   This is 
exactly  the problem of dependability versus reliability and precision.  

Scales are more reliable and precise than observations alone - that is you will get a consistent 
measurement (reliable) if you weigh the baby several times and that measurement is fairly close to 
reliality (precise). 

What she is talking about is dependability.  Here, any observation that you make:  listening for 
swallows, watching for swallows, using a stethescope (such as Cathy Genna does) to listen for 
swallows, asking mothers about the feeling of the pulling ----- all of these are no different than 
test weighing in terms of watching a feeding.  When you say that test weighing falls prey to this 
problem, all of the other means of estimating intake do so as well.  Other measures are as much 
influenced by dependability as test weighing if not more so because of their lack of reliability and 
precision.

The ONLY way that anyone using any means of measurement could capture the entire daily picture 
would be to sit with a mother for 24 hours.  Now, we all know this is not feasible.

Regardless of whether you choose to use a less reliable, less precise instrument or a more reliable 
more precise instrument to determine "intake" from your observed feeding you MUST at the very 
least:

1) ask in depth questions about how the observed feeding compares to other feedings
2) estimate the growth rate

Then on top of that you have to look at the entire picture.  This is where having support groups or 
some other means of follow up for mothers whose babies are not gaining well is extremely 
important for getting a more complete picture so you are not over or under supplementing.  This 
is important for moms who must pump because we all know what a drag that is for all but the 
moms who need the control that a pump provides and even more important for infants that 
unfortunately need some formula.

Best regards Susan Burger

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