Magda draws attention to :

>The 1999 update of the Cochrane trial is now transmogrified into an article
>in the March issue of the Archives of Disease in Childhood (the journal of
>the Royal College of Pediatrics and Child Health):  Is routine growth
>monitoring effective?   A systematic review of trials.  Garner, P,
>Panpanich, R Logan, S ADC 2000 82 197-201

This is really hot stuff, and it is so challenging, I worry that it will
disappear. The Prof is questioning something so routine, so taken for
granted, so much a part of life like eating and breathing, that it will be
largely  ignored, even as a topic for discussion within his own
journal....as he suspects, the idea of a trial might not even get past
Ethics Committees.
>
>In addition to the article is a Commentary by Prof DP Davies, who has won
>his way into my heart with his words:  "I wonder whether the measurement of
>weight...should be an investigation of possible abnormality rather than a
>routinely carried out primary clinical measurement as -- for example, the
>measurement of haemoglobin where anaemia is clinically suspected?

Not that great an analogy, though.....pregnant women get their haemoglobin
levels checked routinely, and I know in the US, babies get their iron
levels checked routinely (not done here, unless there are clinical
indications, or a toddler is on a very restricted diet).


>"Comments over many years from mothers who have derived little satisfaction
>from regular weighing, and who have sometimes suffered unneccessary worry
>support my anxieties.

Yes - he's actually listening to mothers. What a great guy!

The slight problem is - and I have often said this - that dispensing with
weighing is risky, unless mothers and their care providers have other ways
of knowing everything's ok.  This doesn't have to be rigid counting of
nappies, or ticking boxes on charts, or timing or counting feeds....it's
more a question of observing baby behaviour and being responsive to it.

In a culture which finds it very, very difficult to feed ad lib, and where
mothers are encouraged not just by too many  HPs but also by every possible
social pressure to get the baby into a routine, to limit feeds, to not
'spoil' the baby, routine weighing can possibly provide a safety net.
Babies who feed infrequently and who sleep a lot are thought to be 'good'.
If those babies aren't weighed, they could fall through the net. I have
come across a few situations where it was *only* the weight that alerted
mother and HP to a potentially dangerous situation.

I get too many calls from mothers who feel *bad* about just feeding their
babies when they or their babies want to. Like the call I had the other day
from a mother of a 2-week-old who was miserable unless near or on the
breast.....'but I don't want to be picking him up when he cries - he'll
just get used to it.'

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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