I agree with Jan. However, ABM has a protocol (#3) on supplementation that may be helpful. Check www.bfmed.org.
Gail Hertz
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On Feb 14, 2013, at 3:56 PM, Jan Barger <[log in to unmask]> wrote:
> Germaine said:
>
> *************************
>
> <<Hi All, there has been discussion lately about not supplementing for
> weight loss until 12%. Does anyone have any parameters, research or
> information about this in their practise. thank you Germaine Lambergs>>
>
> **************************
>
> When, oh when are we going to start looking at the whole picture and not
> just a number on a scale or a percentage? Some of our pediatricians and
> nurses have started saying to moms in the hospital, "Oh, your baby is down 7%
> today, we are going to really have to watch it." I actually had a mom come
> see me, and when I asked what the baby's weight was in the doctor's office,
> she said, "I don't know. He just told me she was down 10% and I needed to
> see you."
>
> What do I mean by looking at the whole picture? Well, how many times has
> the baby peed & pooped in the first couple of days? How much fluid did the
> mom receive? Was she induced or augmented with pitocin? How much edema
> does she have? Maybe the baby has an overabundance of fluid and is just
> recalibrating back to normal? Was the birth weight accurate? Is this really
> a breastfeeding issue, or is it related to something else?
>
> In the olden days (and yes, I have lived thru them), we used to weigh
> diapers to determine baby output. I think we need to go back to that. Then we
> can decide if 7% or 9% or the "magic" 10%, or even the 12% Germaine is
> mentioning is even valid.
>
> It's 48 hours. Baby weighed 8# at birth. He is now down to 7-2 (11%).
> Panic city. Call the doctor! Call the nurse!! Call the lady with the
> alligator purse (full of formula)!. But did ANYONE look at the output? Did
> anyone look at the baby? Is he dry? Is he lethargic? Has anyone watched the
> breastfeeding technique? Now -- if this mom was induced/augmented and has
> a lot of edema, the possibility exists that her milk is not going to "come
> in" for 96 hours or thereabouts. Has she done RPS? Is she hand
> expressing with pumping? How often is baby going to breast?
>
> So -- a very long answer to a very short question. And the short answer
> is, "stop looking at numbers and look at the baby." And if your
> observations tell you that the baby isn't doing well regardless of the numbers -- then
> the second short answer is "Feed the baby!"
>
> Jan Barger, RN, MA, IBCLC, FILCA
> Lactation Education Consultants
> Wheaton IL
>
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