The scenario Virginia describes is exactly what happened/happens here. On 
the basis on one test weigh, mothers are told they are either under or 
over-feeding their babies.  "Over-feeding" was/is a common diagnosis here. 
Mothers are then told to limit the feeds, i.e. 7 minutes each side instead 
of 10 minutes.  At the next visit mother often doesn't have enough milk.

On the "under-feeding" side, I have observed some mothers experiencing a MER 
only  after 5 to 10 minutes of suckling in the first few days.  In the baby 
clinics, mothers usually feed 10 minutes each side, and usually sitting in a 
group - very intimidating for new moms - it's a wonder the MER happens at 
all!  There has been a slow phasing out of test weighing in baby clinics - 
still a way to go though.

Like all technology, it needs to be used appropriately, with a sound 
knowledge base to interpret the results.  I will never forget one mother who 
came to our private clinic (when we still had rooms).  We heard very slow 
footsteps coming up the stairs.  Took a history from a very nervous mom, all 
was going well.  She asked if I was going to test weigh.  When I replied 
that we didn't routinely do so she almost cried with relief.  She was just 
dreading the "test".  What if she failed?

To be clear - I am not opposed to pre and post weighing.  Depending on the 
situation, I would rather weigh a baby once daily for a day or two.

Jean Ridler  RN  RM  IBCLC
South Africa   [log in to unmask]

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