Debbie Colbert writes about babies whose birthweight is suspected to be higher
than it would have been if the mothers had not been 'overhydrated' for
epidural anesthesia, who then lose more than 10% by the second day of life.

I am wondering why the babies are being weighed at all on the second day.  We
don't do it here, not anywhere in Norway to my knowledge.  We aim to weigh
babies at birth and then at least once again: at discharge or on the third
postpartum day, whichever comes first.  If mother and baby are in the hospital
more than 3 days, baby will be weighed on the 3rd day AND at discharge, even
if there is only one day in between.  We know they lose weight up to about the
3rd day, but most of our babies have started to gain, or at least stopped
losing, by the 4th day.

The reason we don't weigh them before the third day is that we assess them by
observation of respirations, color, and feeding behavior, as well as what is
coming out in the diapers.  We expect to see some meconium within the first 24
hours, ditto urine.  If we haven't seen urine by 24 hours, we start fretting
enough to scrutinize diapers even more closely, and of course we do a quick
top-to-toe visual exam of the baby to be able to say it isn't dehydrated.  No
lab work at that point, and they always do seem to pee within 36 hours.  A
baby who is hesitant about feeding will arouse concern, not always leading to
rational efforts to convince them to take the breast.  Weighing is not part of
the picture before at least 48 hours have passed since the birth weight was
recorded.

Since the reason we are weighing them is to see that they are feeding well, we
don't worry too much about whether a breastfeeding has occurred shortly before
the weighing.  If the amount of milk baby takes is enough to make a big
difference in its weight, we want that weight 'credited' to the baby.
Likewise, if we have just removed a big juicy diaper full of mustard- or
pesto-like stool, we don't worry too much if the baby's weight is down quite a
bit, because we know that within a day or so it will have turned around as
baby is obviously getting plenty of food.  And we would rather not even know
to the gram what the baby's weight is doing between birth and the third day.

For those of you with access to MIDIRS, the midwifery digest from England,
there is an excellent article about weighing babies in the first week of life
by Lactnetter Magda Sachs, along with a pediatrician who I hope will forgive
me for not remembering his/her name.

Someone asked earlier, last time a discussion like this was up, whether it
really has been clearly established that babies get 'waterlogged' if mothers
are hydrated by IV in connection with epidurals.  I don't remember the answer
to that query.  Anyone else?
cheers
Rachel Myr
Kristiansand, Norway

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