I'm working with a first-time mom (it's my sister in law) who delivered via
c-section last Tuesday (after induction of labor with pitocin, artificial
rupture of membranes, and copious amounts of IV fluids; culminating in the
c-section because of prolonged pushing and suspicion that baby was "too big"
to pass thorugh mom's pelvis)  At birth, baby weighed 8 pounds 1 ounce, and
at discharge was around 7 pounds 9 or 10 ounces (mom can't recall exactly).
Today, at 6 days PP, baby weighed 7 pounds.  He is nursing less than I'd
like (every 3-4 hours, for a total of about 8 times per day), and I've
recommended that mom encourage baby to nurse every 2-2.5 hours.  Milk supply
is good, mom feels let down and baby's latch is good, although he sometime
has difficulty due to mom's flat nipples.  (we're using shells in between
feedings to help and mom reports that they are improving her nipples).

All in all, this pair seems to be doing relatively well in my impression,
excpet for the weight gain.  I saw baby the day he was born, and he looked
swollen with fluid from mom's IV, in my opinion. If we go by the birth
weight, he's lost around 14%, but by discharge weight (which seems to me to
be a more reliable indicator, since he'd been able to pass the excess fluids
by that point) it's only 7% or so.  Am I wrong in thinking that this pair
will be just fine by increasing nursings and that this "drastic" weight loss
isn't problematic?

Theresa Belville, LLLL, IBCLC hopeful 2004


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