Weighing in on Baby Scales: Do you really need one?
With the advent of the hatch scale, many new parents are using the scale/changing table to get serial weights on their newborns. But how much information is too much information? Keep reading to see my thoughts on baby scales.
So, if you can't tell from the look on my face, I am not a big fan of baby scales. Now, I am not saying there aren't times in my private practice that even I recommend and, in some cases, prescribe a rental scale to ensure adequate milk intake and growth. But those instances are few and far between.
How much information is too much information?
“Most moms complain of increased anxiety and stress around the weight and feeding times.” - Rue Khosa
Living in the tech and engineer heaven that is Seattle, I have become very accustomed to new parents asking whether or not they should invest in a baby scale. I get it; most of them are data-driven and need to see the numbers. However, I prefer to teach parents to focus not so much on the numbers, especially in the early days, but on understanding and recognizing the signs of health and wellbeing in their new human.
Why? So many factors affect how much weight loss a newborn will experience in the first five days of life. We expect them to lose up to 10% of their birth weight as they learn to breastfeed and regain it by day 10 - 14. However, several factors may conflate the weight loss, from how much IV fluid mom received while in labor to how soon the nurses weigh baby after delivery.
What does healthy look like?
It is significantly more critical for parents to understand how to assess if their newborn is feeding well and thriving at breastfeeding during the first few weeks than to know their daily weight. Here are the questions I want ALL new parents to be able to answer YES to during those first few days of life:
• Is your infant mostly waking up to feed and at the very least staying awake and engaged at the breast?
• Are the wet and dirty diapers, at a minimum, at least equal to the days of life. Day 1, one wet diaper and one dirty diaper. Day 2, at least two wet and two dirty diapers and so on?
• Is the pee clear or very light yellow?
• Is the poop turning to a lighter shade of green as it transitions to a yellow/mustardy color?
• Have you noticed any changes in your breast? Are you leaking colostrum or becoming more engorged?
• If you are breastfeeding, do you hear swallowing, and are you seeing good jaw movement?
If you answer YES to all these questions, it is more than likely that your tiny human is doing well, and getting weight at your first scheduled pediatrician visit should suffice.
However, if you answer NO to any of the above questions, you should see a board-certified lactation consultant (IBCLC). See, numbers may be deceiving, technology may fail, and there is always good old user error. I have seen too many parents take comfort in inaccurate measurements, all while missing clear signs of distress because we as a medical community tend to overemphasize weight gain as THE number one sign of infant wellbeing.
My issue with home scales
"I have seen too many parents take comfort in inaccurate measurements while missing clear signs of distress because we as a medical community over emphasise weight gain as THE number one sign of newborn wellbeing." - Rue Khosa
Now do not get me wrong, weight gain is important, but the reading must be put into context. Instead of driving parents to start early formula supplementation to get to the 1 oz a day, as providers, we should:
• Normalize variations. When we look at weight gain, it's not a finite number. It's a range from 0.5 oz - 1 oz a day.
• Provide better support around breastfeeding and encourage early intervention.
• Refer and collaborate. I have said it before, and I'll say it again, all expecting mothers should have a prenatal lactation consult and breastfeeding class, and after delivery, should have at least one visit with an IBCLC.
• Better educate new parents on red flags before the baby arrives and reinforce them once the baby is in hand and before discharge.
So is it time to scale up?
Well, I will leave it up to you, but whatever you decide to make sure you have identified your professional support system. For breastfeeding families, invest the time into learning as much as you can about breastfeeding before the baby's arrival. And last but not least, find a pediatrician who understands and supports your desire to breastfeed, even if it means we send you home with a scale.
