I'm a little behind on LN's so I've been following this discussion but
perhaps a few days after the fact.  I'd like to weigh in on this thread. So
few things in this life have simple answers and I think the issue of weight
loss after birth and what's normal and what is not fall into that category.
I don't know that we can point to any one factor that may affect infant
weight loss after birth.  Or indeed, that we can eliminate any one factor.
Here are some things that I think are worth considering.
1)  Michel Odent discusses at some length in a couple of his books, the
hormones involved in labor, birth and breastfeeding.  Many, many factors can
affect these hormone levels, even who is present with the mother in labor
(independent of where she gives birth!).  Meds in labor, specifically
pitocin which is used liberally around here, affect how a woman's body
either makes her own oxytocin (so integrally involved in breastfeeding but
also known as the "love" hormone) or develops the receptors to 'recognize'
and utilize what she does make.  Pain meds and epidurals interfere with her
body's production of endorphins, which baby likewise gets a dose of and
which can affect behaviors in the hours immediately after birth.
2) Nils Bergman has brought to our attention what he calls the baby's
"niche" or habitat, which is mother's body.  In addition to this, I recall
a few sessions led by Dr. Linda Black (where is she these days?) where she
goes in depth into what skin to skin does to help a baby recover from birth
...from the catabolic state immediately after birth (think stressful) to the
anabolic state (think calm and serene) that being on mother's body brings.
This also provides a humidified environment, thus causing less loss of free
water (which can make all the difference to babies not nursing well in the
first days) and encourages milk supply even without actual nursing!
3) Much company, which we tend to see in the hospital (people feel free to
visit in hospital when they wouldn't dream of intruding at home), as well as
the busy, noisy environment also leads to sleepy "shut down" babies who
don't nurse as often.
4)  I find mothers just don't know that babies won't come out nursing every
2-3 hours around the clock with one longer sleep at night.  They always
think they are doing something wrong when baby wants to nurse an hour after
they just fed it.  That can be the case wherever the child is born, but most
likely the moms who deliver at home are better educated re: what to expect
with breastfeeding and thus, more likely to feed the baby as often as
necessary and not use pacifiers or supplements.  

So I think there are many factors that can be considered to influence weight
loss in the early days of nursing.  The truly amazing thing is that humans
are adaptable.  Babies survive the weight loss if it's not too extreme.  I
always like to remind people of the lesson we learned from the Mexico City
earthquake of...what ...20 years ago or so.  When the hospital was buried
and some (5 I think) newborn babies were dug out alive 12-13 days later, who
had not eaten in that length of time, for their mothers were killed.  They
were dehydrated, but once rehydrated had NO lasting effects of the early
deprivation.  The "experts" explained that babies are born with brown fat to
tide them over until mom's full milk supply came in and these babies were
warm (it's Mexico after all) and they shut down after a brief period of
crying to be fed, so that they burned few calories.  That is a lesson I
share with moms.  One of the ways they can help their newborn, especially if
they are not feeding great yet is to not let them cry and keep them warm
(close to or on them). Whether it is "normal" or not for babies to lose
weight, many we work with do.  What we can do, in addition to assisting the
mom with feeds, is instruct her how to protect her baby from unnecessary
weight loss.  That is empowering to parents!

Marsha, whose son (hospital born but home by 4 hrs old) was one lb over bw
by one week, but whose dd (also hospital born, home early) struggled to meet
the minimums for 2 months d/t dairy allergy! 


~~~~~~~~~~~~~~~~~Marsha Glass RN, BSN, IBCLC~~~~~~~~~~~~~~~~~~~~~
Mothers have as powerful an influence over the welfare of future generations
as all other earthly causes combined.
~~~~~~~~~~~~~~~~~~~~~~~~~John S. C. Abbot~~~~~~~~~~~~~~~~~~~~~~~~~

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