I agree that the percentages of weight loss are more likely to be
used by HCP's who have less experience in recognizing when a baby is
doing well or not.  As a doctor or LC gains experience in observing
a feeding, assessing a baby's growth and fat with the eyes, and
comes to know what a thriving baby should look like then they can
move away from the numbers to "know when to worry".

I had a baby and mum referred to me at 6 weeks who really worried me
despite her low end of normal weight gain. Baby looked like a
newborn.  Baby had returned to BW by three weeks and was gaining
about 3.5 - 4 ozs per week.  Over the previous 5 days the baby had
gained 3 ozs.  So the numbers didn't show me the same picture as I
saw looking at the baby and observing a nursing session.  With some
changes in positioning, latch, breast compression, increasing
feedings per day and occasional supplements with hindmilk, the baby
began to gain.  Week 7 was 4 oz again but baby "looked fatter". The
next week the baby gained 6 ozs and looks great and is more alert.
So the numbers need to be combined with the clinical stuff to be
helpful.

I think the numbers are still worth recording so that a trend can be
seen and so that assessment is complete.  But like all other
assessments it should be done correctly.  Using different scales and
HCP's, as Jack suggested often happens, leads to useless data.  That
doesn't mean weighing regularly shouldn't be one part of the
infant's assessment.  It just shouldn't be the most important part.
--
Janet Vandenberg, RN, BScN, IBCLC
Newmarket, Ontario, Canada
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