Felicia,

I saw your original message, but didn't have any references for you.  I'm
curious as to why your client wants ammunition that more than a 10% wt. loss is
okay.  I know that it always makes me take a close look at the situation when a
baby's weight loss is getting to 10%.  Does she expect this to happen from past
experience?  There's so many factors to consider--the age of the baby, was
baby's weight appropriate for gestational age to begin with, how's the baby
acting, how dry does the baby look, is mom's milk starting to increase or are
her breasts soft and baby isn't swallowing, etc., etc.

I assume she must be expecting a c-section or this wouldn't be an issue (she'd
be home).  Rather than looking for references to justify a large weight loss,
she might better focus on how to prevent one.  I don't think I'd be seeing the
inappropriate weight losses I do if not for all the obstetric intervention.  How
about helping her plan for minimal intervention in the birth and unrestricted
breastfeeding by keeping the baby in her room all the time?  I also suspect she
could specify in her baby's chart that she "forbids any oral fluids without her
written consent" or something of that nature.

Becky Krumwiede, RN, IBCLC, Wisconsin, hospital practice
Who finds herself using ABM *way* more than she ever would have expected.
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