Karen Clements writes:
<<If you are not weighing for another 4 days from
birth some of those babies may actually have lost more that 10% but are on
the climb back up again by Day 4 and you don't know that cause you didn't
weigh them in between. I guess its a case of what you don't know wont hurt
you (LOL!)>>

<<[Re: daily weights] Too much weighing (I think)and then the poor mother
goes home petrified
that her baby has loss around 10% of its birthweight,they are undermined,
losing their confidence, reaching for the formula. All of this is so hard
to 'undo' and build their confidence up again.>>

There are two sides to looking at the "daily weights" question, and you
brought them out for us, Karen.  I think the "what you don't know won't hurt
you" approach might be fine in a supportive environment, where a mom knows
how to evaluate the quality of her baby's breastfeeding in the early days.
After all, if the baby is latching well, swallowing a lot, pooping a lot, are
we worried?  No!  Do we NEED daily weights?  No!

But in a truly supportive environment, the mom--well educated about
breastfeeding--would also know that some weight loss is normal on Days 2 + 3,
and that the baby is expected to turn the corner by Day 4, and she could
avoid being petrified and watch for the first day of weight gain as a
confirmation that everything's working well.  I believe that weights--if they
are accurate--really do give us some reliable documentation of what's going
on with the baby's feeding.  [Of course, as any adult dieter knows, you have
to adjust (mentally) for recent feeds and recent major diaper events that
would make small fluctuations in the overall curve of weight loss and gain.]
And if the mom is lucky enough to be in a supportive environment, then by
definition she and her baby will be followed up until everybody knows the
baby is feeding well and gaining well.

A story from my past:  My first child was born in 1968 at 37 weeks, 5 pounds
11 ounces, and I knew almost NOTHING about breastfeeding or babies.  She
nursed maybe five times during our three-day hospital stay, which included
spending the first 24 hours NPO according to the standard practice of the
time.  What they did with her overnight or in the nursery they didn't tell
me, but she and I were together for just five "feedings" a day, at 5 & 9 AM,
1 & 5 & 9 PM, and she slept soundly through about half of those "feedings"
(although I tried to wake her, and she had no drugs on board).  I assume that
they weighed her daily, but they didn't tell me what her weights were after
that initial one.

I had read that it wasn't good to weigh the baby at home--too
anxiety-producing for a nursing mom--but my husband and I were curious, so
after a couple of days at home we rigged up a homemade balance scale that we
could hang in the doorway.  I recall that the balance weight we used was a
five-pound bag of flour.  We did some fancy mathematical calculation that
involved how far from the fulcrum the baby (in a basket) and the flour bag
were when they came into balance that would give us her weight--and we got 5
pounds 6 ounces!  Well, I knew THAT had to be wrong--she was guzzling my milk
and pooping up a storm!  So I said to myself, I guess we built the scale
wrong, and we abandoned the whole idea of weighing her.

Later, when I had learned more about birth and breastfeeding, I realized that
she very likely did lose that much weight, and the scale may have been right
after all.  But at the time I had the confidence of the new convert to the
cult of motherhood, ready to toss the scale in the trash because I could FEEL
that the baby and I were doing fine.

And--just to round out my story with the rest of the true facts--when she had
her first pediatrician visit (at one month of age, because that was the
standard practice of the time) she was only 15 ounces over birth weight.  It
was like a blow to the solar plexus when the doctor, who I'd never met
before, suggested formula supplements, and I was just barely able to gasp
that I wanted to try nursing more often to build my milk supply.  He OK'd
that plan, and the next weight check was scheduled for one month later.  In
that month she gained 2 pounds 5 ounces.

There are so many things to think about this story.  1) how cavalier (and
sloppy) was that early HMO's whole approach to borderline premature babies,
weight gain, breastfeeding, and mother support; 2) how much I'd like it now
if I had more data points on her weight curve, to anchor my hazy maternal
recollections about what worked and what didn't work; 3) where did I get the
courage to tell the doctor I wouldn't use formula--well, that's an easy
question, because I had reached that "breastfeeding is a sacrament" feeling
and wouldn't allow anything to come between my daughter and me.

There's an example of "what I didn't know didn't hurt me--lucky for us things
were working all right."

I'm still a believer in giving parents information--as long as you take the
time to tell them what it means for them, deal with their questions or
apprehensions, and make sure they will have continuing support.
Unfortunately, in the U.S. healthcare "system" (which sometimes seems more
like "chaos" that like anything "systematic") TIME and GOOD FOLLOW-UP are two
things you can't always count on, and SUPPORT has been slipping away for
generations.  So because the system is bad, does that mean we should withhold
information because we don't have the time and resources to help parents deal
with it?  I think not.  Once again, all we need to do is fix the system.  No
wonder we get burned out!

But, just so I don't end on a "down" note, let's remember that breastfeeding
itself is a beautifully-designed system.  All we have to do is help the mom
and baby set it in motion, and then we have all those hormones and beautiful
belches and loaded diapers helping the mom "keep the faith."

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