Best practices for breastfeeding ‘success’ are constantly evolving as more information becomes available. For example, it used to be common to advise new moms to nurse their baby for 20 minutes per side. We now know that not all complete nursing sessions last for 40 minutes. This is especially true as your baby gets older and becomes more efficient at nursing. The current recommendation is to “watch the baby, not the clock”. This means you should observe your baby for cues of satiety, rather than focus on time at the breast. Another common misconception is that it is a necessary part of a breastfeeding consultation to do a weighed feed to establish efficiency. Is a weighed feed helpful for breastfeeding success? Absolutely not. In fact, we feel that they are detrimental and can provide a false sense of security or concern.

Before we go on, we want to be clear: at Blissful Birthing, our definition of “success” with breastfeeding is fluid. It is based off you meeting the goals that you have set for yourself. If you want to nurse your baby for a week and are able to do so, then we are so happy for you! Just as if you want to breastfeed for 6 months and you are able to do so.

Is a weighed feed helpful for breastfeeding success?

There are a few points to consider regarding a weighed feeding during a breastfeeding consultation. First, I want to establish what we mean by a “weighed feed”. This is a practice whereby a lactation professional will weigh your baby before you nurse and after. The volume of milk transferred during the feed is, supposedly, the difference in weights. Supposedly. Several factors can influence the precision of this measurement including, but not limited to:

• Quality of the Scale
  • The scales necessary to measure out weight to several hundredths of a gram are expensive. They are not the $50 scale you would buy at a baby store or online. They start around $1,000 and increase in price from there.
• Calibration of the Scale
  • How often is the scale calibrated and tested for accuracy and precision?
• How the Scale is Stored
  • Is this scale kept in an office on a firm, flat surface? Or is it put in someone’s trunk and transported to different locations? Keeping the scale in one location makes it more likely to provide accurate and precise measurement than the latter. However, studies have shown these measurements are, on the whole, not  reliable.

In fact, a 2006 article in the Archives of Disease in Childhood: Fetal & Neonatal Edition (found on the National Institute of Health’s website), found that this is not the case. They determined that:

“Test weighing is an imprecise method for assessing milk intake in young infants. This is probably because infant weighing scales are not sensitive enough to pick up small changes in an infant’s weight after feeding. Because of its unreliability, test weighing should not be used in clinical practice.”

What does that mean? It’s fine to weigh baby for a data point. But that single data point should not be used to create an action plan (such as supplementation).

Why do Blissful Birthing’s CLCs take this stance?

So why do we answer the question, “is a weighed feed helpful for breastfeeding success?” with “no”? I’ll explain our main points:

A weighed feed provides you with exactly one data point

A single data point does not provide you with much information at all. It cannot be used by a lactation professional to assess baby’s feeding habits or to enable them to make educated suggestions on how to proceed. The only information that can be gathered from a weighed feed is how much baby took in at that feeding (and, as we discussed above, even that isn’t reliable).

• Even if we were to assume that this is a reliable and precise method to determine how much baby has consumed, you would need many data points, over at least a 48-72 hour span to find an average of how much baby was consuming at each feed. That would make it a little more possible to make an educated action plan.
• Like adults, babies’ intake varies from one feed to the next. Think about it – do you eat the same volume of food for breakfast as you do for dinner? That’s why a feed with a “high” or “low” transfer is not indicative of baby’s overall feeding pattern.
  • Comparing time at the breast to milk transferred can lead to new mothers obsessing over the amount of time baby is at the breast nursing.
    • A shorter feed does not necessarily mean less milk transfer – sometimes babies are hungrier and will drink at a more rapid pace, thus consuming the same or greater volume of milk in a particular amount of time. Babies become more efficient at nursing as they get older. As such, it would not be unusual for them to be at the breast for a shorter amount of time than when they were younger.
    • Think of an adult who eats a salad for lunch and then states, “I don’t know why I’m not losing weight. I ate a salad for lunch.” Well, we don’t have any other data. Is this individual’s daily consumption in line with their goals to lose weight? Or are they going home and having a pint of ice cream, package of Oreos, and a glass of wine for dinner? Do you see how obtaining just one data point (ie transferred volume during one feed) is useless in assessing a situation or creating an action plan?

Weighed feedings can lead to unnecessary supplementation

This can have a negative impact on your breast milk supply. Just because baby didn’t transfer much milk when you were doing the weighed feed doesn’t mean that all feeds are low volume. And, if they all were, more frequent nursing sessions can help baby get the volume needed for weight gain.

As an example, if baby nursed for 15 minutes and transferred 3oz per the scale, what are you going to do with that information? If the lactation professional feels (for whatever reason) that the baby should be having 4oz per feeding that leaves you with pumping to supplement or formula. Which is fine, however, if baby does actually “need” that additional ounce and is not getting it from the breast, baby’s demand will not regulate your supply. As baby gets bigger and is taking more at a feed, you will likely need to supplement with more, too. This leads many new moms to believe that their body isn’t making enough milk to feed their baby.

What do your CLCs look for during a breastfeeding session?

We are not quite sure where the idea came from that it is necessary to weigh a baby before and after nursing to assess the “success” of breastfeeding. Our CLCs look at the session as a whole. This allows them to make suggestions to improve the experience for both mom and baby. The main aspects we look at are:

• signs of satiety in baby
• positioning of you and your baby
• how your baby is latching
• flange fit, if you are pumping

Other Blogs You May Find Helpful

Tips for Building a Breast Milk Stash
Breast Milk and Alcohol – What Every Breastfeeding Mom Needs to Know
Boost Your Milk Supply: A CLCs Take on Galactogogues

This blog is for informational purposes only. It does not take the place for feeding advice provided by your child’s pediatrician.