Tina Lavy asks: "If seeing a baby under a month or so, would you consider it
a standard of practice or part of a routine assessment for an LC to weigh
the baby - preferably without a diaper and clothing?" and responses have
been quick.
If I as an IBCLC am seeing a baby under a month old, it will be for some
non-trivial breastfeeding problem.  I usually need to know as part of my
assessment what the baby's birth weight was, what the lowest weight was
after birth, and whether the baby is now, at the moment I am seeing
them, gaining weight as expected.  I most often can't divine this
information by any other means, so I place naked babies on sensitive,
calibrated scales intended for that purpose, following the manufacturer's
instructions for the use thereof, and do the math myself with the results.
The baby must be weighed naked for the weight to mean anything in this
context.  Weighing a clothed baby one time tells you nothing useful
whatsoever  so if I heard of an LC doing that I'd wonder whether they
understood the first thing about why we weigh babies at all.  Weighing a
clothed baby before and after a single feed may in certain
rare circumstances be an appropriate thing to do but never as a routine
observation in my practice.

If the mother and baby have come straight from a well-child check the same
day, the baby will have been weighed, naked, already, and I don't weigh them
again.  The other information is in the baby's record from the hospital I
work in.  But if the check was as much as a day before, I weigh them.

Where I live the IBCLC credential confers no professional privileges or
rights in the legal system, and my work experience with breastfeeding
problems is as a hospital staff midwife who specializes in breastfeeding
guidance.  But if IBCLCs had an authorization as a free-standing profession
in Norway I would expect that all of them followed this practice when seeing
babies *for breastfeeding problems*.  If the IBCLC, working solely in her
capacity as an IBCLC, is seeing babies and mothers with no problems, several
thoughts spring to mind, the first one being, what are the mother and baby
doing there?

Rachel Myr
Kristiansand, Norway

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