>    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.

Jan Ellen Brown mentioned the situation where there is adequate to
large intake of breastmilk but poor weight gain, weight loss, etc and
felt that test weighing was a good tool here.

I see this scenario occasionally, but it is usually a less serious
disorder - usually undiagnosed food intolerance or allergy. I have
never thought that test weighing was useful (but then I don't have
any scales!!).

I think it is fairly obvious when the baby's output is copious (both
wet and dirty - and the character of the dirty ones is also
informative), then there must have been plenty 'going in the top'. So
if the weight gain is not there, then it is time to look at *why*
this baby is unable to utilise the milk efficiently. Why is it going
in one end and out the other?? IMHO I really don't think counting up
the grams (mls) that went in at *one* feed would give you much extra
useful information.

Perhaps it is just a different way we work. I must admit, I tend to
be with Heather on this issue, but that could be because we in
Australia are more like UK in this area than the US.

Another snippet that comes to mind here is that in some research work
(namely Peter Hartmann's) they have found that they get more accurate
estimation of milk transfer at a feed by test-weighing the *mother*
than the baby. But you need specialist, very accurate scales and you
need to do an additional 'test-weigh' without feeding to calculate
'insensible' weight (water) loss over an equivalent period of time to
the feed, and take that into account with the result. I'm not
suggesting that this is something that would be practical for health
professionals to do, but I thought it was interesting to throw in and
so help us to consider the normal errors involved in any test
weighings.

******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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