Valerie draws attention to the other possible factors present in that
situation, in particular....
>
>How do we know that this infant didn't drop even more weight at home? She had
>dropped to 8% below weight on day 2 of discharge and was seen on day 8--still
>at 8% below weight. This infant might have actually lost more weight from
>day 2 to day 8. Which would mean that this infant actually was starting to
>gain back the weight she had lost.
Also, we have discussed here before the arbitrariness of birthweight.
It seems birthweight is A Big Deal - here in the UK, anyway - and ok,
I have no problem with parents knowing it for social and emotional
reasons (as long as the weighing ritual does not interfere with the
far more important social and emotional 'stuff' of greeting the baby
at the breast).
But we have very little *clinical* evidence that birthweight (as
opposed to birth plus 24 hours or whatever) is crucial to know, in a
healthy, term baby. Birthweight is not A Big Deal clinically. Why
not let the first mec be passed, a few urinations, let the baby
snuffle up some mucus...whatever? And then weigh? Would that not be a
more accurate figure to base clinical decisions on?
Currently, clinical decisions are taken about what the baby's
subsequent weight, weightgain, rate of gain, need for food, ought to
be, based on this Big Deal of the birthweight.
I'd really like to see some good research done on this. So many
interventions in breastfeeding come about as a direct result of
concern about the birthweight and current weight in relation to it.
In Enabling Women to Breastfeed (Renfrew, Woolridge, McGill, 2000,
which is a wonderful resource I have only just read through, but will
refer to often, I know) the authors say 'there is insufficient
research to guide practise in making decisions about which babies may
genuinely need additional feeds[......] 'and they ask the question,
'what level of weight loss in the baby should result in
supplementation?'
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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