A poster asked if a chart is available and one has been mentioned, along
with a few comments on cut-offs individuals find acceptable (sorry, haven't
taken note of all the individuals who have posted).
I think it is important to note, that, as with any weight chart, before
leaping into using it, there should be questions like 'what data set is this
based on?' and 'is it applicable?'. Rules of thumb are all very well, but
saying that such and such a percent is acceptable and so and so isn't begs
the question: what next? When do you intervene, what interventions do you
perform, in what order, by whom, what do you do about re-weighing, etc?
Some posters have alluded to elements of this, but not mentioned a whole
protocol.
In a research study in Glasgow such a protocol is described, with times of
routine weighing, cut-offs for breastfeeding referral and medical referral
(with differeing cut-offs for breastfed and infant formula fed babies) and
also including percentage of weight loss and time taken before birth weight
regain. The impact on breastfeeding in terms of stats at 6 weeks was
investigated, but not the qualitative impact it had on women. You can read
about this study in two papers:
Macdonald PD, Ross SRM, Grant L, & Young D (2003). Neonatal weight loss in
breast and formula fed infants. Archives of Disease in Childhood Fetal and
Neonatal Edition 88, F472-F476.
McKie A, Young D & MacDonald PD (2006) Does monitoring newborn weight
discourage breast feeding? Archives of Disease in Childhood 91, 44-6.
I think this study is interesting, but I dont' know any more about it than
what I read in these publications. You may know that in the UK there has
been a long-standing debate as to whether freqeunt early weighing is
discouraging to breastfeeding, and that is why I am sad that there were no
qualitative results with this study.
I think weight loss tables or a chart might be useful, but, as with the
growth chart controversies for longer-term postnatal growth which we know
have gone on for the last few decades, it is important to make sure that
such a tool is based on good data, collected with thought about its
parameters, and also that it is accompanied by good descriptive literature
as to its appropriate use.
Magda Sachs, PhD
Breastfeeding Supporter, The Breastfeeding Network, UK
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