The Development of an Accurate Test Weighing Technique for Preterm and High-Risk Hospitalized Infants

Background: Test weighing, or weighing the infant before and after breastfeeding to assess milk intake, in which weight gain in grams is converted equally to volume of intake in milliliters, is a controversial topic in the literature. This study was initiated to identify variables that impact test weights and to develop an accurate test weighing technique for preterm and high-risk hospitalized infants. Methods: Test weights were performed on a sample of hospitalized high-risk infants with and without leads who were bottle-or nasogastric-fed. Volume consumed was compared to weight gain to determine whether the developed technique was accurate. Results: In each group, with or without leads, only one measure of actual intake versus test weight result was found outside the confidence limits (95%), and only one measure was found outside the clinically acceptable difference of +/-5 g. Correlation coefficient (r(2)) values of weight gain by test weight to volume of intake were 0.998 for infants without leads and 0.997 for infants with leads. Conclusions: The data from this study support the use of this test weighing technique as an accurate, objective assessment of the measurement of breastmilk intake after a breastfeeding session, thus allowing medical decisions regarding supplementation to be based on objective data rather than inaccurate clinical indices of the quality of infant feedings at the breast.