Rachel spoke eloquently about weight loss, saying,  among other things:
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<<Isn't it odd that people doing the fearmongering about weight  loss, and
often setting policies and procedures for maternity units, are so  CLUELESS
about lactation phyisology?>>
 
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In our hospitals in  the US, women are overloaded with IV fluids during 
labor.  A liter  (sometimes 2) of fluid prior to the epidural to prevent 
plummeting blood  pressure.  PItocin added to keep the labor going at an 
appropriate  clip.  Lots and lots of fluid.  There are good studies that show that  
the more fluid the mother gets during labor, the more weight the baby loses  
after delivery.  Again, uh -- DUH???
 
The question  becomes, why are we not weighing diapers?  It would give us a 
better idea  of what is going OUT of the baby.  We chart numbers of voids 
and stools,  but have no clue really as to whether or not the baby voided 3 
ml or 13 ml or 23  ml.  And how much DID those three mec stools weigh?  So 
yes, we need  to discuss what goes in and what is going  out.
 
We've talked before  -- wondering why we have to have "birth weights" done 
so early....that perhaps a  "birth weight" would be a lot more accurate at 
24 hours after birth than  immediately thereafter.  I've been crabbing about 
weights being done in  L&D for a long time because it involves separating 
mom and baby before the  first feed is accomplished -- and I've not yet 
figured out how to weigh the baby  without taking the baby off the mom's  
chest/abdomen.
 
Doing a "Building  Bridges" program in Grand Rapids last week the 
participants clued me  in.....evidently the computer can't generate a plate and chart 
for the baby  until the weight is entered.  And that has to be done before 
anything else  is done (we are now slaves to our computers and nursing them 
rather than our  mothers and babies).  So -- separation is the order of the 
day so we can  Get. Our. Work. Done.  I told 'em that we should eyeball the 
baby, make up  a weight for the computer and correct it later, but that 
didn't go over very  well.
 
Anyway -- that's  another story for another day.
 
But -- back to  weighing diapers.  At least someone could do a study on 
them to see what  the average output is -- and see if it is more if the mother 
is induced vs  stimulated vs lots of fluids vs few  fluids....
 
Maybe we could  eliminate some of the fear mongering?  At the very least, 
before we start  supplementing babies that are down 8 and 9%, could we at 
least LOOK at the  clinical record to see how many times they peed in the first 
24 to 48  hours???
 
Please?
 
Jan Barger, RN, MA,  IBCLC, FILCA
Wheaton  IL



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