Just saw Rachael Austin's post about the baby who took off 450 g by day 3
and another 10 by day 5.
From the description, my hunch is that the lowest weight actually occurred
on day 4 and it's just as well for everyone's peace of mind that we don't
know how low that was.  The weight recorded on day 5 could well have been on
the way back up toward birthweight from this unknown lowest weight, and in
another couple of days I would expect it to have gone up another 200 g or
so, with no changes in how mother is caring for baby. 

We have a graph we use in hospital, with weight in 10 g increments plotted
on the y-axis against time in days on the x-axis.  It is so easy to
extrapolate the likely minimum weight afterwards if you plot the
birthweight, weight at discharge or on day three, whichever comes first, and
then weight when they next have contact with you.  A physiologic course
looks like a 'V' - straight down to lowest recorded weight and then straight
back up again to birthweight and beyond.  If there is some problem, the loss
may be abnormally large or it may take longer before the baby starts to gain
and/or the baby may regain the loss very slowly, giving the graph the
appearance of a wide-troughed 'U' or a big hammock.  I can picture the graph
on this baby very easily, because I see it all the time in normal babies who
generally require nothing more than slightly increased watchfulness for a
day or two, to reassure the staff that all is well.  

Babies who lose that much, often take time to catch it up again.  The plan
you made sounded like more than was necessary. Even with the asymmetric
breasts, she only has one baby and she has one breast that looks normal.
Likewise, the length of third stage would not concern me now, though if baby
was suckling through that first alert period after birth before the placenta
had detached and started the whole hormone cascade that allows lactogenesis,
it could explain why baby may have stopped losing weight on day 4 (assuming
my conjecture is on the mark) rather than on day 3, which is more often what
I see when babies have been feeding well from birth.

I don't think I would be very anxious about this one despite the large
initial weight loss, because everything else in the case sounds so good.  My
plan would have been to encourage mother to carry on as before, and weigh
the baby again the next day. If she lived too far away for that to be
practical, I would get a reliable phone report on what was in the nappies in
the 24 hours after you weighed baby on day 5, and make provisions to see the
baby if stooling diminishes or baby seems unhappy or lethargic.

Rachel Myr
Waiting in suspense to hear how this one turned out, in
Kristiansand, Norway

 "I think that taking life seriously means something such as this: that
whatever man does on this planet has to be done in the lived truth of the
terror of creation, of the grotesque, of the rumble of panic underneath
everything. Otherwise it is false."  --Ernest Becker

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