Several thoughts: I read the article that Linda cited and it gives us a good idea of the variability of normal BF. We can use this to talk to inexperienced moms about what they can expect. Haven't we been doing this already? New moms do like to have some idea of what to expect, and I think they deserve it. So if an exclusively BF baby only BF 4x in 24 hours, this would be red flag. Similar to the advice about turning the clocks to face the walls, I use this analogy when talking with moms who worry about when to feed the baby (some may have heard this from me already). I ask them to pretend they are on a tropical island with no clocks, calendars, bottles, formula, or pacifiers. They have plenty to eat because their partners are bringing them fish, shrimp, mangoes, pineapples and the like. I ask them this, "if your baby has BF on the right and then the left but seems hungry again in 20 min, what will you do? Will you give him the shrimp then?" No, they say they would BF again. Right! This is to show they don't have to grab a formula bottle in this case. This is sort of a light-hearted discussion of baby watching and trusting your body. Re wrong info with strict feeding times and lengths: I am cynical and think maybe this is a concerted effort by some people who do not support BF. Why all of a sudden, with much new and evidence-based info about feed variability in journal articles and conferences, are we seeing this kind of info taught at CLE courses???? About test weights, again. People usually do not check their blood sugars or carefully meausre their food intake, however sometimes this is done when their is a disease process or something out of the norm. Same applies with test weights. They may be useful for preterm infants or non-thriving infants to help assess and monitor their feeding effectiveness. The usual thing is to NOT be obsessed about these things and to just "feed the baby." Again, as in my first paragraph, the moms do need some guidance about what to expect, and I think we do a good job with this. They need to know there is going to be variability, again the article recently cited showed this: sometimes baby will take one breast, sometimes two, and sometimes "switch nurse" or cluster feed. Some babies develop a pattern of always taking only one breast, some babies always take both, some vary. Aren't we already talking to moms about this normal variability? One last thing: A scale is probably not necessary in a truly BF supportive facility, culture, country. Even for a tiny preemie, he would be kangaroo'd and just learn to BF over several weeks. This is just not done in most places in the USA. Even "normal" mother/baby dyads are not allowed the access and synchronization either in hospital or afterwards. I can't begin to tell some of you how far from the ideal many places are. It seems to me that the European and Australian LCs are in a more BF supportive place than the USA. In USA, Birth centers with midwives are very different places than typical maternity hospitals. I think that's why some of us use scales because the normal BF behaviors don't happen and then the downward spiral happens so quickly and then more intense interventions are needed. Also, the availability of follow-up is not really there. How many LCs get to see a mother/baby dyad having trouble, repeatedly, say every few days for a few weeks??? This is what it would take to really follow up and get them going, without having a scale. This would be great, but it is just not feasible in lots of settings. Hospital LCs don't usually have a lot of time set aside for lengthy followups. If the pair goes to the pediatrician for follow-up, breastfeeding can often get derailed. So, the whole culture has to support Bf - that's the bottom line. Laurie Wheeler, IBCLC, MN, RN Mississippi, s.e. USA *********************************************** 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