We've had a busy week at work, so more mothers have taken 'early' discharge,
which here means before 72 hours.  Also due to the hectic state of the ward,
not all mothers have been subject to so much 'help'.  Funny how that often
leads to painless establishment of BF.  For example, I have had one dyad in,
not a first baby, birth weight 5020 g (11 lb 1 ounce) and this was an
entirely normal birth, baby almost born en route.  On the 5th post partum
day the baby weighed 5180 g, or just over 11 lb 6 ounces.  No supplements
though mother was quick to point out that he had been given 20 ml of plain
water on the second day, in an attempt to give her a half hour break from
BF.  20 ml is just over one tablespoonful.

When looking at how much babies lose, it is the percentage of birth weight
and not the actual volume of the loss that matters.  In some places the CS
babies are larger than the vaginally born ones, purported feto-pelvic
disproportion being a prime excuse for CS.  So the number of ounces they
drop may be high, but if you calculate the loss as a percentage of their
birthweight it may not be any higher than the other babies.  We use a graph
to plot weight at birth and on the third day, which is the first time we
weigh them after birth.  A big baby almost always has a steeper drop because
the squares on the graph are the same size no matter what the baby's
birthweight was.  A 2 kg baby may fall 180 g, which is nearly 10%, but
plotted on a graph it looks like a gradual slope over three days if you
compare it to a 4.5 kg baby who loses 300 g.  But the second baby has lost
under 7% of its birthweight.  All this is much easier to keep straight in
the metric system.  Calculating what is 10% of 11 lb 1 ounce is beyond me,
and luckily that baby only went up in weight so the percentages wouldn't be
of any consequence.

Try the exercise for yourself.  Take graph paper, and let one axis be weight
and the other axis be time.  See how it looks much more dramatic for a big
baby to lose 5% in three days than for a small baby to lose 10%, when we all
know it's the one whose percentage weight loss is greater, who is in more
jeopardy.

Rachel Myr
trying to make numbers tell the truth in Kristiansand, Norway

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