But it's OK, you're snuggled up with mum and her familiar voice, her skin and now her scent help you adjust as she tends your every need. You've just settled down for a nap when out of the blue someone strips you starkers, then plonks you on a thin piece of paper, on top of cold hard plastic scale like a stranded beetle. Your startle reflex is triggered, your hands come up to your face and you let out a big shout, WTF is going on?
You might kick your legs and wave your arms, why is nobody moving me you shout? Hello! I'm letting you know I'm really not OK with this!As a result the numbers on the display dance a Cha Cha up and down as watchful eyes wait to see where it will land (if you lay still long enough).
Why do many insist on weighing babies in this way? I don't get it, especially given we don't use analogue scales for weighing anymore.
When I'm baking I could weigh fluid by tipping it all over my digital dinky number, or I could put a bowl on first - tare the scale and then add the liquid.
The liquid weighs exactly the same whether it is in a suitable receptacle or not, yet one is far more practical than the other.
Why is weighing a baby different?
Why can't we pop a snuggly blanket on the scale, tare them and then place baby prone, a position they are generally much happier in. Arms and legs are less likely to flail as the startle reflex isn't triggered - making everything quicker.
In fact do we even have to undress baby at all?
I'm not convinced we do and for some babies this may be even more important. Premature infants for example need a cardigan, hat and blankets - even in a hospital. Their skin is thinner and maintaining body temperature is something that can be hard work for them - stripping them off also often prompts lots of crying in these babies too, burning energy and generally stressing their system.
So, back to the baking analogy above. If I put a bowl on the scale, a cup inside that, an egg cup inside that - tare them and then add fluid; the reading is just as accurate as it would be just with the bowl.
Applied to babies, if parents are aware their baby will be weighed why can't they dress baby in a vest and/or babygrow and/or hat depending on the weather/baby's age, and have a spare set of identical items on hand (as per multipacks)
Place the above along with a new identical nappy and a snuggly blanket on the scale and then tare Remove the vest, romper and nappy and they will tip to a negative balance.
If you then place baby dressed in a clean nappy (ie change it immediately before weighing), vest and romper as above on top of the blanket prone - tada, you have the same reading as if you stripped baby butt naked and laid him flailing on his back.
Even if you do want to strip baby down, placing a young baby on his tummy on a soft surface, tucking his arms and legs underneath him if he is still quite fetal and curled can help lots.
Really, the stranded beetle is not an essential part of weighing your baby - remember, tummy to the scale if you don't want them to flail...
I can understand your view point, however, the weighing process isn't 'just' a weighing process. We check babies over, check for marks/dimples/abnormalities all over their body and obviously this cannot be done when the baby is dressed. Yes we need to be gentle and cause the least stress possible to the baby, but sometimes a completely stressless weighing process is unaviodable.
ReplyDeleteRuth these checks aren't done every time a baby is weighed? And that doesn't explain why they can't go on their tummy?
ReplyDeleteSometimes a completely stressless weighing process may be unavoidable, but I don't think that means we shouldn't strive to make it so.
Having been a SCBU nurse, I can say that we DO lay a soft blanket in the scales, tare and weigh. And we try to do weighing when baby's due a change of clothes and nappy anyway (I always tared the scales with a soft blanket and an open, clean nappy then returned baby right to parents, if present, who would dress baby). It's only some that have such thoughtless practice, not all or even most.
ReplyDeleteOK well based on my experience of 2 babies, one prem and lots of weighing - he was never weighed prone on a blanket Nor were any of the other babies in that SCBU or our local clinic. Speaking to the mums I work with, the vast majority experience supine weighing....
ReplyDeleteThey're lucky mums who have a forward thinking nurse like yourself/your unit :)
My community MW weighed my son in a vest (no nappy) I assumed she didn't think the mass of the vest was significant (though he is a big, greedy lad).
ReplyDeleteMy children were weighed with a sling and a digital fishing scale.. they remained all cuddled and warm and were checked separately while in my arms.
ReplyDeleteWeighing babies in the way described is like most hospital procedure. Easier for the nurse or doctor while disregarding what is best for mom or baby.
baby no 3 weighed naked, hanging from midwife's hanging scales very happily 5 weeks ago. he was weighed in at babyballet purely to wake him up (stranded beetle) which it certainly did, but helped get help with his latch. other weigh ins with other children I've usually put a small soft blanket on the scales- a peice of paper is just pointless imo. If you want I can email you a pic being weighed?
ReplyDeleteOur third baby wasn't weighed at birth (long story) but it was evident that she was completely well and healthy so it wasn't a concern. I understand why prem babies have to be weighed but if all is ok with baby at birth do they even need to be weighed. I know this time I have only had said baby weighed once and she is coming up 2.
ReplyDeleteAnd this style of weighing can make mums feel paranoid and under-the-microscope. Given that most mums are aware of the safeguarding role of Health Visitors, I have known of many mums who have asked to keep a baby dressed and been told they have to strip them naked, clean nappy and all, and have felt like they were under suspicion somehow. I have never noticed anyone look at my baby to check for abnormalities etc at a busy weigh-in! (Just didn't go second time round)
ReplyDeleteExpecting newborns to be dressed in the same nappy and outfit for routine weigh ins as often as birth, 3 days, 5-8 day, 10-14 days is not a practical way forward. That sounds far more stressful than stripping the baby down trying to remember to have that uniform at the ready.
ReplyDelete30-50g so perhaps the weight of a nappy vest could be the difference between a baby being readmitted or managed in the community, there is a reason for using weight as part of the toolkit for newborns and it's really important that it is accurate.
Every midwife I know uses a blanket and are perfectly familiar with the tare button. Was it Alison Blenkinsop that mentioned weighing prone this week? I can see why it may work for some babies, after all them liking it was why they used to be put down to sleep like that. Modelling putting a baby down prone probably isn't a great idea for a HCP.
Another plus of stripping them down is that they are then gunning to be nursed so it leads into a very easy way of rousing the sleepy newborn and gives parents the confidence to use it as a method too. It is also as previously mentioned an opportunity to check baby over, not just for child protection but for signs they may not be medically well and may need to see a doctor. Most people don't notice the check being performed as its very subtle.
Why can't we do it on normal scales with mum? Mum can jump on the scales, get her weight, strip baby down (or not), and give baby to mum who jumps back on scales
ReplyDeleteWho mentioned a "uniform"? Having s spare same vest and babygrow is impractical and stressful, really? Given the amount of multipacks of vests/grows the shops sell, I always assumed them quite popular. It doesn't need to be the same each time either does it, as long as mum has a spare that's the same? Although note I do say straight after that: "Even if you do want to strip baby down"...
ReplyDeleteI'm well aware of the need for accuracy, hence me highlighting it isn't any less accurate to weigh in same items.
Does every midwife you know place baby prone as well? I find it a teeny bit difficult to believe though - do they ask parents to ensure they have their own blanket handy? Or do they ALL weigh in nappies too? As I thought the whole just having paper was so it could be changed for each baby and wiped clean if they pee, which is common if stripping baby down?
I disagree re putting a baby prone isn't a good example - don't most promote "tummy time" LOL It also surely provides the perfect "in" to explain why we weigh babies like that but why it isn't a good idea to put them to bed like that :) Reiterate the safe sleep message as it were. Also SCBU/NICU place babies prone regularly so we already have HP's "modelling" this.
Did Alison Blenkinsop discuss prone weighing this week? I haven't read it if so, but then I haven't been reading the groups I typically do this week (beyond specific threads) as have been manically busy. However just in case you're inferring my blog fodder is based on someone else's comments, can I just point you in the direction of the last paragraph on this entry which was written September 2010 http://www.analyticalarmadillo.co.uk/2010/09/is-my-breastfed-baby-getting-enough.html ;) It was also mentioned at the LCGB 2007 conference.
What you're saying (I think) is it's OK if baby gets stressed and flail because at least that wakes them up to feed? I show parents ways to gently rouse their baby which most appreciate, a quiet alert state is the most productive for a young baby trying to feed. AND FWIW the baby clinics I attended with mine didn't have any bfing support, just weighing.
Not sure about the checking over aspect - several people recently have commented their clinics now offer scales at the back for mums to use without HP guidance, how on earth do people cope without covert baby checks there? ;) Excuses me thinks, not valid reasons.
Aside from her first weigh in at birth (an hour old or so maybe & never been dressed before... thinking back I'm lucky I didn't cop a massive meconium poop in that time she was bare on me under loads of heated blankets) my baby girl has been weighed dressed. The nurses have gotten me to change her into a fresh nappy kept her in just in a onsie, on a blanket, and they reduce an amount... like 30grams... from her weight.
ReplyDeleteShe's also been stripped and played with and looked up and down a few times by nurses or mws but not placed on a cold surface.
Which has been great. Can't see why you'd do it differently.
I have to say, my babies were always weighed on their bellies with a soft towel or blanket under them. I remember one nurse wanting to do it the "stranded beetle way" and of course my daughter was NOT happy. I turned her around and she calmed down instantly. The nurse was amazed.
ReplyDeleteThe nurse at my GP didn't worry about undressing and changing nappies once we all knew that my babies were feeding well. she'd just estimate the weight of her clothes and took off a standard amount for the nappy. A gram this way or that doesn't really make a difference, anyway once they are more than a week or two old. It's so much more important to see how the baby behaves and whether they have an appropriate number of wet and soiled nappies.
Most other health checks were performed while I held my babies. Only rarely did they have to be placed onto a surface.
I'd be interested to see where these lovelly hp's are that use blankets. I know thay here in Glasgow when my two were little 2008 and 2010 it was the cold scales, stripped bare, stranded beetle approach and then berating the baby for making a fuss! With DD1 I didn't know any better and felt like I had no choice. With DD2 I just didn't go to the clinics and if I felt there were any problems went to the gp.
ReplyDelete