I know this has been discussed in the past but I still have questions.
In the past a 10% weight loss was considered within normal limits and the
expectation was a baby would regain this weight by 2 weeks of age.
Then, some in the lactation world felt 10% was too high and stated they were
more comfortable with saying 7% was normal and 10% would send up red flags.
I also know that this is more of an obsession for the USA and that makes me
sad sometimes.  I wish we used other criteria to be concerned on how well a
newborn is doing and not on weights.
Now, hear me out and I am looking for some science to understand all of this.
    If a newborn on day 1 (who does not feel so great just going through the
birth process) normally has an intake of 7-15cc.  Then on day 2 has a normal
intake of 10-30cc.  Also the literature states that a newborn has a layer of
extra fluid on board to fold them over until they recover from birth. So one
would expect weigh loss and why would we expecting any weight gain at this time?
    Why would a baby loss >7% in the first 24 hours?  Why would they loss 10%
or more by 48 hours?  Should we be concerned with this, or question that
there is an error because physiologically this does not make sense?

Now, I want to share a recent story.  I don't have the exact numbers at hand
but will give the basic details.  A mother, who had previously breastfed her
first child 7 months (2 years ago) had a vaginal birth.  Breastfed in L&D and
the baby always nursed well, getting in 8 or more feedings the first 2 days of
life.  The baby also had good out puts, both voids and stools.  The problem is
the baby lost 10% by 48 hours.  The mother had breast fullness and I observed
active swallowing at a feeding.  My recommendation at discharge was to add
breast compression when the baby slowed down and keep a note of how much
swallowing the baby did.  Call for a pedi appt the following day for a weight check
(mother had a different pedi than the one seeing her baby in the hospital) and
keep tract of the diapers.
The nursing staff and covering pediatrician were very concerned and an order
was given to supplement formula after every breastfeeding for the next 24
hours.  ARGHH!!!!!!
Please help me to understand this weight issue.
Ann Perry RN, IBCLC
Boston, MA

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