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In a message dated 6/25/2006 3:16:09 PM Eastern Standard Time,
[log in to unmask] writes:
I go by these guidelines: well, term newborns lose about 5-6% and regain
this loss once mom's milk comes in, so they are gaining by around day 3 or
4, provided they are truly being bf and in almost continuous contact with
mother (i.e. frequently and with milk transfer and STS). I consider 7-8% wt
loss to be cause for concern and I consider 10% to be serious. Taking 2 wks
to regain b. weight is abnormal, IMO. Therefore, after the first 24 hrs, a
well term baby might lose around 2-3%. If the child has been NPO, briefly on
oxygen, delayed initiation, separation, etc. or if the child is preterm (36
wks is preterm!) then this is not a normal term newborn situation and you
will have aberrations. I have also seen quite a few weights written down
incorrectly and also seen large wt gains which were also errors. A well,
term newborn losing 10-17% in 24 hrs or less is something I don't think I've
ever seen in 20-something years.
Laurie, thanks for your response. This will be very helpful. I agree that
7-8% is what I think should be the upper limits but that is in an ideal world
and where I work is anything but "ideal"! There is way too much separation
of moms and babies. Part of this is brought on by hospital routine but many
times it is the parents who keep sending their babies back to the nursery.
My few hours with them does not always have the impact I would hope for.
Silly me!!!!
Now, here is another question. If a baby was delivered with a mom who had a
long labor with an epidural and lots of Pitocin and IV fluids, would they
have more voids and therefore a greater wt loss in the first 24 hours?
I don't believe I have ever seen a study that was looking at babies' outputs
and wt loss.
Anyone want to take this on as a study?
I will start calculating our babies' wt loss in the first 24 hours and see
where they fall.
I will also ask the pediatricians to give me their data on this. My goal
right now is to get rid of formula supplementation as the "first" choice in the
orders.
Ann Perry, RN IBCLC
Boston, MA
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