While we're on the topic of weighing babies and other ways of assessing early
breastfeeding, let me share a nugget from Dr. Larry Garnter's article on
jaundice in the April 2001 Pediatric Clinics of North America, p 395.

He's talking about why it's best to avoid giving water or glucose water to
new babies (because giving water raises the baby's bilirubin level).  He
attributes the perception that babies *need* extra water to people's concern
that they are not peeing enough.  (And as we've said before on Lactnet, who
knows how much normal babies are *supposed to* pee in the first days?)

Here's the quote:
"Newborn infants receive adequate water in human milk to meet their metabolic
needs, which are minimal because of their relatively large water volume at
birth.  If an infant has adequate renal function as indicated by having had
an appropriate volume of amniotic fluid in utero, it is not necessary to
monitor urine output in the first days of life.  Undue concern over perceived
inadequate volume of urine often leads to water supplementation of the
healthy newborn and increasing jaundice."

Implication: somebody who is involved in the obstetrical/birthing side of
things--who knows how much amniotic fluid the baby had and how wet the
doctor's or midwife's shoes/knees got when the baby was born--needs to be in
touch with somebody who is involved with the pediatric side of things, who
will be counseling the mother on breastfeeding and baby assessment.  If the
baby was peeing adequately before birth, then we know the kidneys are OK.
Until the milk volume increases ("milk comes in") and the baby's milk intake
increases, it's best *not* to obsess over the number or amount of voids.  As
long as the baby is going to the breast well and often in the first three
days, then we should see more happening in the breasts and more wet diapers
by Day #4.

Now we just have to figure out what to do with all those sleepy babies who
don't do much of anything in the first three days...  My guess is that
keeping them skin-to-skin with mom would be the best thing to do while we're
deciding whether to worry about them.

Chris Mulford, RN, IBCLC
Swarthmore  PA
(north-eastern USA)

AAGH--I forgot to sign my last post.  Sorry.  It's Re: frequency of weighing
babies (long). Did you know it was me?

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