With interest I have followed the discussion on test weighing. One of the
things I asked myself is: what kind of information do I want to get through
test weighing that I can't get anyway else? And what consequences does a
test weighing have for me
a. When the baby has been drinking "enough"
b. When the baby has been drinking "not enough"
To the first point: some others have already said, you don't look to the
numbers of the scale, you look to the mother and to the child. When a baby
is loosing weight very rapidly or doesn't gain weight after a few days, when
he doesn't have loose breastfeeding stools, when the urine is dark (see
table Lawrence), I know, something is wrong and something has to be changed
(positioning, latch on, more frequent feedings and and and, and perhaps even
supplementary feeding). But what would change this scenario when I knew the
baby has been drinking in this feed 10 ml? or 20 ml? or 30 ml? or 60
ml?.........Even then I don't know how much the child is needing as
supplementary feeding. I personally have the opinion, that the tables we
have for this are not very accurate for the individual child. On the other
hand: when a baby is thriving, when he is gaining weight, active, loose
stools, for me it is unimportant if, in this special feeding I am testing,
the child is drinking 10 ml, or 20 ml, or 30 ml, or 60 ml. He is thriving,
and that's what counts. When the mother is uncertain, if she "has enough
milk" (for instance, while the baby is very fussy) I can explain to her,
what signs she can see at her baby. And of course I also can cheque the
positioning, latching and and and......After all, there are lots of other
reasons, why a baby is fussy. She perhaps has to learn "baby-watching".
And to the second question: to my opinion, we just don't know enough about
how every individual child is becoming enough milk. What is "enough" for
this child? What is "enough" for a single meal? Some have lots of small
meals, some have a few big meals, by most of the children the amounts are
changing from meal to meal. Same with the mother. How will she react on
test-weighing? I suspect, some will react with hampering MER. I don't know,
if the amount that I find this time will be equal to the amount the baby
gets next time - or will be more....., or will be less......To be
consequent, I would have to weight all the meals of the day (and night) and
perhaps even the following day.
For me, a regular weighing (every day or two days in the first days of life
until the growth of the child is very clear and after that with the regular
visits) helps me to have a global idea of growing, and even then I must
realise, how "normal" growth can be different from child to child (we
already had this discussion)
Elien Rouw, MD, Bühl, Germany. With many greetings from the Black Forrest
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