Sorry for my sloppy keyboard habits. A kind soul asked about my mispelled word. It is not growth tradgetory or tragetory as I so rapidly banged out on my keyboard - it is growth trajectory. As in the angle of the curve. As for how I convince pediatricians about how to interpret growth curves, I guess I am now picking my battles with pediatricians since we have our trendy hip Tribeca group taking a dim view of our practices here in Manhattan. I'm used to doing anthropometry surveys in developing countries where even the primary health care workers (lower on the totem pole than nursers or MDs) usually do a better job than I've seen in most pediatrician's offices in this country. When I see how anthopometry is typically measured, I can understand why Jack Newman thinks its all useless. Nevertheless, in certain circumstances and in the international nutrition literature - there have been some notable successes in the use of growth charts. So, I often take the pediatrician's reports on weights with a grain of salt, especially when they have balance scales. Michel Cohen may take a "dim view of our theories and equipment" but any equipment can be used well or not, whether it is tongue exercises, feeding devices, positioning, or weights. Weights are just one of many tools we can use appropriately, but should never be used in isolation. I think in the area of weights I would suggest doing it yourself. The scales we use are accurate to 0.1 oz which is far more accurate than most pediatrician scales and possibibly even the hospital scales. The scale is but a snapshot of what goes on. BUT if you do follow ups and/or run support groups you can get a better picture of how things are progressing. Make sure to calibrate the scales periodically, that the baby is undressed to the diaper and that you zero the scale with the diaper on the scale so you don't have to do the math. Whenever I get a client who prefers grams I go for it. Pounds and ounces are so difficult in the math department. I have two stories about looking at the whole picture. One was a baby whose pediatrician had measured her intake a few hours before my former supervisor saw the baby. This baby would fall under the clinical definition of marasmus, which I saw frequently in developing countries. The baby took about 0.2 oz by trying every feeding method available and promptly threw up. The weight loss was close to 20%. We called the pediatrican who said that she had measured that the baby had taken 1 oz during her office visit and that the baby did not need to be hospitalized. The baby had two convulsions in the middle of the night and the parents did not take the baby to the hospital until the morning. The baby had suffered from a series of strokes. This is a case where the pediatrician did not look at the baby, but looked at the scale. The other was more recent with a baby who had a greater than 10% weight loss by day 3. I went into the consult on day 4 expecting a train wreck because the pediatrician had said that the baby was doing fine and didn't need supplementation. Sure enough, the baby had gained weight and took 2.5 oz at the feeding from one breast and passed out completely satisfied. This was a case of the pediatrician actually looking at the baby and what the baby was doing. Of course, I also have lots of stories where the scale was very helpful to me, but its just one piece of the puzzle. Best, Susan *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html