Rob, I think that the 10% weight loss or any percent is not as scientific as
it sounds.  LC's have always been stung by the criticism of not being
scientific enough, but this is not the way to do it.  It is pseudoscience.
It frightens the mother and the staff (just look at some recent posts).  And
you are right.  A baby who breastfeeds well will make up the "loss".  And a
baby who loses only 2% and does not actually drink milk will not.  We just
seem to bow down to the scales as if they were infallible.  But they are
not.  You only have to look how babies are weighed (at least in some
institutions) to realize that the weights are not accurate.  And weights are
written down wrong, sometimes.  I have seen this myself and done it myself.

At the Toronto conference on Friday, (where we had superb guests such as
Kathy D--hope it's not Toronto that made her testy, and Kathleen B), I told
the story of a nutritionist whose baby was weighed at birth, and then next
morning.  Result? 500 gram weight loss.  Now, instead of questioning the
scales, instead of observing the breastfeeding (which, according to the
mother's own observations--not necessarily correct--was breastfeeding well)
everyone got on the mother's case to supplement.  To the point where she was
threatened with being reported to the Children's Aid!!!!  This is horrifying
and despite being a rare case, I hope, it emphasizes what is wrong with this
approach.  By the way, the baby did fine, without supplements, and she
nursed him until he was 5 years old or so.

My post regarding the Island baby did not get to Lactnet (something was
wrong), though it got to the Island, but again I would disregard the %weight
loss.  How is that relevant?  It is obvious the baby was not doing well.  I
personally would not have hospitalized the baby, especially under the
conditions there (Pace! Linda), but gotten the baby feeding. Unless the
hospital was super supportive with knowledgeable staff (unlikely in Canada,
but possible on Vancouver Island). But even now, the latest report mentions
almost back to birthweight as if the birthweight were some sort of Holy
Grail.  What is it with all these rules?  It is not the birthweight.  It is
what the baby has done since intervention.  And if the baby has lost a lot
of weight and then starts gaining, he may not be back to birthweight by a
certain date, but who cares?  As long as the situation is fixed.

Jack Newman, MD, FRCPC