While it may be commonly BELIEVED, I don't know that it is "commonly KNOWN"
that IV fluid "inflates" birth weight.  Jan Riordan did a poster
presentation at the ILCA conf. in Acapulco on a study that she did that
found no association between IV fluid and excess weight loss that could be
attributed to inflated birth weight.

Many of us have discussed edemic mothers and postulated that perhaps there
is water-logging of babies that leads to inflated birth weights (making
subsequent dramatic wt loss "OK" ?) however, there is no evidence of this
and Jan's study to the contrary.

It is so important not to speak as if theories are fact.

New work presented by Jane Heinig and Laurie Nomsen-Rivers at the LLLI conf.
in Chicago and the ILCA Acapulco conf. respectively (soon to be published)
suggests that normal breastfeeding produces recovery of weight loss by about
the end of the first week.  I agree with Laurie Wheeler that the downward
trend of weight loss is troubling.

  With regard to 'nipple confusion'.  The medical definition (Neifert,
Lawrence, Seacat, J Peds, 1996) suggests that you can't call it confusion if
it is, in reality, a baby with a feeding dysfunction who can't make bfg work
in the first place.  Nipple confusion refers to a baby who was feeding and
gaining normally who loses ability AFTER bottles are introduced.  This baby
doesn't sound like he was ever feeding well or the weight loss wouldn't be a
problem.

I would support supplementation of this baby, altho my preference would be
to immediately shore up and protect the milk supply, and to use human milk
(which clearly the baby isn't accessing).

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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