Dear Lactnetters,
    Elisheva makes a valid point about when "intake" weights (we don't call
them "test" weights at my office) reveal a large amount of milk transfer.
    I have worked with 3 cases of undiagnosed cystic fibrosis  where intake
was on target or beyond expectations and the fact that the baby was losing or
SWG was a mystery.  In those cases reporting to the ped that intake looked to
be optimal or  even moreso was instrumental in an eventual diagnosis.
Weighing pre and post filled in a big piece of the puzzle.  Conversely, I
have talked with several moms that were told to "nurse more often"  and/or
"milk is too weak" (not by LC's!).  Many weaned because breastfeeding was
problematic.
    Stooling was a misrepresentation of intake in  these cases because these
babies were malabsorping and having tons of bowel movements (albeit some
green and smelly...one mom had been counseled for oversupply...the ol'
chicken and egg... baby nursed "all the time" because of
metabolism/malabsorption and the green stools were linked to oversupply).
    If a baby with metabolic or malabsorption condition(s) presents
unknowingly with impending FTT or SWG, I think the adequate/abundant intake
weights reinforce there is something amiss with baby and the HCP needs to
look for a possible cause.  Often times it takes the focus (and suspicion)
off breastfeeding and on "why" the baby is not gaining.
    In these cases, too much of a good (superior!) thing was still not enough.

Jan Ellen Brown RDH IBCLC
Charlotte, NC USA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html