Dear Pat and Nancy

 

You make me blush.  Thank you.

 

It took so long from when, as a new graduate nurse, I first saw a woman in
labour receive a bolus of 500-1000 mls for an epidural until I could explore
the relationships among maternal fluids, neonatal output, and newborn weight
loss.

 

I hope that we will treat the weight loss as a correction and not drive
women crazy with +++numbers (e.g., if you got 2500+ mls then your baby can
lose X% and if you got less than 1200 mls then your baby can only lose X%).
This approach suggests that the current 7% or 10% are valid red flags and
they are not.  

 

Before this study, I did a systematic review (Open Medicine) to determine
reference newborn weight loss.  There was no basis for 10% as a limit and 7%
appears to be a mean or median in the patterns of weight loss we found - if
7% is the red flag then we are saying that half of the babies are in crisis.
We lack evidence to tie any percentage of loss to morbidity and mortality
and newborn weight loss, in itself, is NOT a disease.

 

There is more work to be done, and I encourage others to try the protocol
that was published in IBJ along with the research paper.  Check your
maternity areas and see if the newborn diuresis is happening where you help
breastfeeding women and their families.

 

Joy

_________________________________________

Joy Noel-Weiss RN IBCLC PhD

Assistant Professor/Professeure adjointe

École des sciences infirmières/School of Nursing

University of Ottawa/Université d'Ottawa

451 Smyth RGN3249C

Ottawa ON Canada K1H 8M5

Tel./Tél. : 1-613-562-5800 x7669

Télécop./Fax : 1-613-562-5443

Courriel: [log in to unmask]

 

 


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