Hi Kathy
I am not sure what test weighing has added to the picture in this story.  It
was clear that this baby was not getting sufficient milk from the weight
loss and elevated bilirubin. I imagine there were other signs of
insufficient intake too  - persistent meconium or no poo at all; low urine
output; urates;  face not relaxing as he fed and fists still tightly shut at
the end of the feed.

If the scale was not available, you'd still suggest that the mother feed
more frequently, use breast compression, switch sides as soon as the baby's
suck swallow rhythm slowed and express between feeds. You'd know when intake
increased because you'd see output improved, the jaundice would begin to
resolve, output increase, baby more alert and demanding, relaxed after
feeds.

Did the test weigh change anything about the way you managed this case or
did it just put a number (of ccs) onto an existing diagnosis of insufficient
intake?

Nina Berry BA/Bed(Hons) Dip Arts(Phil)
Breastfeeding Counsellor
PhD Candidate - "Ethical Issues in the marketing of 'Toddler Milks'"

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