Naomi asks about the history of the 10% newborn weight loss rule, so I googled it, and found a very informative article.


http://emedicine.medscape.com/article/976386-overview 


<Numerous conditions can affect neonatal fluid and electrolyte balance, as well as renal function. The presence of several of these can be suspected on the basis of information found during the prenatal and neonatal history.

A newborn's fluid and electrolyte status partially reflects the mother's status. For example, excessive administration of oxytocin or hypotonic IVF to the mother can cause hyponatremia in the neonate at birth.> 


All in all, this judgement must potentially be a very complicated thing for the neonatologist or the pediatrician who "calls the shots".  


Keeping really accurate track of both oral and IV intrapartum fluid intake, and various drugs with side effects on the kidney, may be more important than previously realized. It would certainly seem to be a help for researchers, who are on a very important trail to further discoveries. This includes both the amounts received before placental separation, in relation to the babe, and the timing and total intrapartum fluid intake, and any extended postpartum IV intake in relation to pre-L-2 edema of the breast, onset of lactogenesis 2 itself, as well as possible superimposed post L-2 edema. Many mothers are discharged around 48 hours after birth, at which time, the iatrogenic sequellae may just be about to become visible. I am convinced that important information for anticipatory guidance at discharge, as well as to share with the pediatrician, could result from this research. 


K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC, Dayton OH

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