Hi, Marie.  I'd like to say first that I agree with you that the mom you
describe is seriously over-using test weighing.  However, I guess I take
comfort from the fact that this same mom may have been personally unable to
continue breastfeeding and may have switched to formula, if she didn't have
the ability to do these measurements.  It is a similar situation to that of
the availability of breast pumps leading to more moms pumping and bottle
feeding.

We have a serious challenge in helping families where their mindset and
socialization have so strongly influenced them.

I had the opportunity to hear Paula Meier talk a few times over the past
years.  She explains your question about does a gram of milk equal a
millileter something like this.  One milliliter of breastmilk weighs more
than 1 gram (because as you said, it is not plain water).  So just doing the
conversion from grams to mls leads us to overestimate the number of mls.
However, the baby does have insensible water loss during the feeding (even
tho this is kept down because the baby is weighed and fed in clothing and
diaper), so the post weight is a little low. Dr. Meier said that these two
corrections balance each other out.

After hearing her speak, reading her articles and working with hundreds of
babies, I have come to believe that a few babies and moms benefit from test
weighing.  Her studies where experienced LC, perinatal nurses and moms
estimate feeding volume from careful observation and then compare it to
actual test weights are persuasive to me.

Hope these thoughts help a little in answering your questions.

Toni Pestro, RN, BSN, IBCLC
Cincinnati, OH

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