Allison,

One more question:  has the 19-day-old preemie with slow gain been weighed on the same peds scale at each visit?  

I've known of a few cases over the years where there were significant discrepancies from one office scale to another in the same office practice, where parents have been needlessly worried about their baby's "weight loss" as measured on a particular scale.  

In one instance, there was a 12-ounce discrepancy for a 6 day old showing as a significant drop below birth weight.  The mother was advised by the peds to supplement baby, and she called for a home consultation the same day.  My BabyWeigh scale weighed the baby at an acceptable weight as compared to birth weight and discharge weight, and all other parameters were appropriate re: high stooling, clear urine, and appropriate milk transfer for age as an exclusively bf baby.  Baby had an appointment for another wt. check at peds office the next day, and the experienced nursing mother (with a science background but not in health care) had already declined the pediatrician's strong recommendation to supplement, continuing with her plans to exclusively bf her baby.  For further reassurance, I gave the parents the option to rent a BabyWeigh scale from the large urban private practice where I was then employed.  The mom declined to rent the scale, content to feed her baby often and record diaper counts until baby's wt. check with peds the next day.  

For the baby's scheduled weight check the next day at the peds office, I encouraged the parents to ask to have the baby weighed on the same scale (the same scale in the peds office), and then to ask to have their baby weighed on a different baby scale in that large peds practice (a small practice would typically have only one baby scale).  When I chatted with the mother after their peds weight check the next day, she said there had been a significant discrepancy of weights on the two different office scales at the peds practice - - so significant that the she and her husband were advised that the practice would either have the defective scale repaired or replaced.   

Given your preemie patient's age of 19 days, I imagine there have been at least 3 weight checks at the peds office since discharge.  How were those weights, and were they on the same scale?  

Deb Swank, RN BSN IBCLC
Ocala FL USA  

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