Dear all:

For every incident that we all have experienced when we follow up cases when inappropriate 
advice is dispensed based on information from a test weighing, I can come up with similar 
experiences where inappropriate advice has been dispensed by faulty observations of a feeding 
that could have benefited from the APPROPRIATE use of the scale.  Mostly, it is because the person 
cannot spend enough time with the mother to get a full picture of the situation or hasn't 
developed enough skills to move beyond basic advice and modify that advice to suit particular 
situations.

We have discussed nipple shields at length, feeding tubes at length, paced upright bottle feeding 
at length.  I think ALL LCs should be familiar enough with these tools to know when they are 
helpful and even more importantly when they are not.  And there are plenty of examples on 
Lactnet about these tools and thoughts on appropriate and inappropriate use.  I think it 
sometimes takes more skill to know when not to use a tool than when to use one.  

The scale is not evil incarnate.  It does not cause the use to spout inappropriate advice.  It is 
merely a tool.  I am sure the advice given without the scale might be just as inappropriate as with 
the scale.  In fact, now that my computer is up and running well again I could probably flood 
Lactnet with a post a day on case studies of such advice with and without using the scale to 
demonstrate that its not the scale that causes advice giving based on generalities that was 
inappropriate to the specific case.

We are humans - that means tool users.  We should not be Luddites hoping that avoiding the use 
of tools will bring us back to a fictional time when breastfeeding was perfect.  That time never 
existed.  There was a time when women did have far more support and opportunites to learn how 
to breastfeed and that is a worthy goal.  But it doesn't mean we cannot progress.  And that also 
doesn't mean that we get overexcited and focus on the tools to the exclusion of many other 
observations that are just as important.  And it also means that we shouldn't overuse the tools.

Don't be afraid of the scale.  Get to know it.  Use it.  Analyze it.  Then figure out if and when it 
might helpful to you.  When it might be useful is likely to be different depending upon your 
clientele, setting and population. 

But don't blame the scale.  It is not dispensing the advice.  Its an inanimate object that can be 
used effectively or ineffectively.  Not more than that.

Susan Burger

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