Hi Rachel,
Our moms/babies typically go home between 24 and 48 hrs postpartum. C/S
birth moms usually go home at 48 hrs, some at 72 hrs if they've had a fever
or needed blood or something like that. If I've observed babies feeding, I
can pretty well predict the ones who have lost the most weight, because I've
seen them feeding ineffectively or infrequently. I usually see the babies in
another 24-48 hrs for an outpatient visit. A typical weight loss would be
less than 7%, the ones who are not bf well usually lose 9 or 10%. The ones
who are really doing poorly are usually 10-14% but I rarely get one over 9%.
These numbers don't worry me much, if at the time I'm getting them, the baby
is now nursing effectively and the milk supply seems to be adequate or
starting to increase. I do like to continue followup until the baby has
shown me he is gaining. If things are looking good, often mom will go to the
local health dept instead of coming back to me (some have to travel an hour)
to have the baby weighed again and just call me with a report. I started the
bf followup clinic with a grant about a year ago, and many moms/babies in
USA  (most) do not get any followup from a bf-knowledgeable person, but get
a 2 wk checkup with the pediatrician.
Even before the milk "comes in" moms typically have more colostrum, a little
bit more fullness, warmth at greater than 24 hrs, and so we can tell things
are starting to "kick in."
Baby diapers are usually adequate in hospital even if baby is not nursing
much or effectively, so I don't think we can go by that, because once they
are home, if things are not going well, the diaper count starts to fall off.
In my experience, it seems babies are at their lowest weight between 48 and
72 hrs postpartum.
I would like to ask all lactnetters to chime in, what kind of followup
program is available in your community?  I think the followup program has
been so important and helpful.
Laurie Wheeler RN, MN, IBCLC
MISSISSIPPI USA

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