Whoa. I think what Dr. Jack was saying, and I agree, is even if you did
not have the percent wt loss calculated, you should be able to see
whether the baby was thriving, in trouble, bf well or not. The
open-pause-close type of suck and the physical exam. So when Nikki says
it is important to know if the baby lost 15% or 23%, I think Jack would
counter with something like "those babies weren't bf, only pretending to
bf." And I agree. And surely in those cases, there are other red flags,
like flaccid breasts, few pees and poops, signs of dehydration,
jaundice, etc. and the "non-nutritive sucking" instead of the gulping
milk suckling. So lets pretend we didn't have a scale or a calculator or
chart handy (say we are helping moms in Central America after Hurricane
Mitch). We should all still be able to tell if baby was thriving, needs
to improve but not in big trouble, or in trouble and needs real fixing.
I personally use weights and "test weights" and percents on some cases
(not all). Of course, this is in conjunction with a history, physical
exam and observation of bf. And all of it helps me to make a decision on
if/when/how much to supplement and if/when/how soon/phone or in person
to follow-up.

Laurie Wheeler, RN, MN, IBCLC
Hospt LC
Louisiana Breastfeeding MediaWatch Campaign
Violet Louisiana, USA
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