I used to weigh myself weekly at the midwifery office in Chico, CA where I worked. I could pinpoint reasons I might weigh less or more. For example: fully dressed and Danskoed, I would weigh almost 5 pounds more -- my Danskos alone were about a pound! Despite what I could manipulate on my own, including drinking a ton of water, or peeing a ton of water, there was one other way my weight could change. This office had two scales. One was digital, and that's where I saw the precision of ounces. The other scale was the old, slide-over-the-doo-hickeys one -- you know, the tap-tap-tap-balance kind? The two scales rarely matched exactly, leaving a discrepancy of two-ish ounces lost somewhere in the hallway between bathrooms.
This sweet little one was born at 35 weeks, 6 days, weighing 5 pounds, 13 ounces. His mom is a doula in Bakersfield, CA -- and a friend. Late preterm babies aren't new to her, but solely breastfeeding is. She has been so proud to nurse him, and even prouder to pump for him. He had to stay under the bili lights for jaundice treatment, and since his official discharge, he has been monitored by his doctor through repeat visits for weight and lab checks.
From a Friday to a Monday, he gained 2.4 ounces, checked on the same scale. Great news for a baby at 7 days, who in there somewhere had lost 9% of his birthweight, right? (Mom also had 3 bags of IV fluids during labor.)
On Wednesday, he had only gained .5 of an ounce, and Mom was devastated. "Was it the same scale?" I asked. She replied: "Same office, different scale." I was surprised they didn't want to verify his weight with the other scale, and this mom didn't think to ask in her postpartum haze as her roller coaster dropped down...very fast.
The doctor asked, "Are you able to pump?" Mom responded with a hearty yes, she had almost 50 ounces in her freezer by now. The doctor then looked at her chart and said "Hmmm, let me go get you some formula. Give him an ounce to an ounce and a half after every feeding." The doctor sent this mother away with a bag filled with formula.
We had more time, the mom and I, to troubleshoot. The first thing we looked at was his output, and he was having 7-8 wet diapers, and 7-8 poop blow-outs in 24 hours -- his stool had been yellow since day 4. Even with jaundice at play, I shared the ABM Protocol for Jaundice, which states "Breastfeeding infants should not be supplemented with water, glucose water, or formula," and that supplements offered, if needed, should be "expressed breastmilk, banked human milk, or formula (in that order of preference)..." I suggested she read that document and arm herself with what the AAP's own breastfeeding specialists have agreed is best practice, so she could ask, why is her baby different than the norm? Why is the doctor suggesting formula versus breastmilk?
All along, I encouraged this mama meet with an IBCLC, and I wondered why her pediatrician wasn't suggesting the same? Mom was making arrangements to do just that. Mom was so worried, the evening of the "weight loss," she offered the baby a bit of formula -- and he threw it up. Reaffirmed by this response, she supplemented him with an ounce of her own breastmilk after each feed.
At the next 24 hour weigh-in, back on the same scale that showed the original gain of 2.4 ounces, guess who was up three ounces in weight? As the nurse brought Mom and Baby to the exam room, they passed by the other scale. Mom asked if they could weigh him there? The nurse agreed. Suddenly he was 2 ounces less in weight! Mom came unglued and her Mama Bear claws started to emerge. The nurse showed a doctor, and the doctor tried to explain it away...this Mama was not having it! She demanded a new doctor! The new doctor apologized profusely as Mom told her everything they had experienced, including being sent home with formula and no further breastmilk or breastfeeding information/clarification. This new doctor was understanding and agreed things weren't handled well.
So there you have it -- 2 ounces to me could be the difference between taking my keys out of my pocket or not. But for a new baby, pre-term and being watched closely (not closely enough?), 2 ounces is huge! The importance of sticking with the same scale cannot be underestimated when looking for true accuracy. It was one of the first questions I asked this mom, and it proved to be the point of contention. I am so proud of her -- she is pushing upstream against society, her doctor's suggestion of formula, and even her own doubts and past history, to listen to her gut and provide the best to her baby.
Way to go, Mama!
♥ four young boys and a boy dog (offspring)