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From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 21 Feb 2009 18:06:32 -0500
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Pam Morrison asks whether a baby can be severely dehydrated/undernourished
and still produce 'normal' amounts of 'normal' urine.  Personally I doubt
that the amounts would be normal and I bet the urine would be measurably
more concentrated than is normal for infants, but as Heather points out,
with today's ultraabsorbent disposable diapers it's hard to quantify output.
 Anuria is a late sign of dehydration/hypovolemia, and a very very serious
one at that.  I realized while reading the posts in this thread that it was
only on moving to Norway I acquired an accurate kitchen scale, because most
baking recipes call for measuring amounts by weight rather than volume. 
Everyone here has baking scales and most people under 30 have electronic
ones on which the difference between a dry and a wet diaper is readily
observable.  Some of them are even accurate enough to do proper
intake/output reckoning, if that is desirable, though here it is rarely an
issue since a baby whose intake and output warrant such close surveillance
will generally be admitted to hospital for whatever the underlying problem is.

When I see brick dust urine on day 3 I don't worry but if I see it on day 7
I am highly concerned, because I've come to see it as one more sign of a
poorly feeding baby. Don't think I have ever seen noticeably yellow urine in
a baby who was gaining weight convincingly either.

I want parents to know that lack of stools for 24 hours in a baby under
about 6 weeks of age is a concern but not an emergency, whereas lack of
urine for 12 hours warrants having the baby examined by a doctor then and
there.  I also believe that if the baby is pooing up a storm, they don't
need to worry about the urine, because it's sure to be there in quantity,
but if they aren't seeing stools, they need to be vigilant about the urine
and respond accordingly.  They should also take steps to have the baby
weighed without undue delay, to determine whether the lack of stools could
be due to inadequate intake - which, in my experience, it generally is in
such young babies.

Rachel Myr
Kristiansand, Norway

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