Several years ago I had the opportunity to participate in a very aggressive
24 hr discharge plan. Mom/baby stayed 24 hr and went home. They were seen
in home during the next 24 hr. Revss on day 4 or 5, unless bili problem
-however by going on day 2 & 4 didn't see a lot of bili problems ;).
With BF babies I saw a slight drop below birth wt on day 2 and came to
expect weight to be at or above birth wt on day 4 or 5 IF nursing was
progressing normally. If I saw a loss or no regain on day 4 it was a big
red flag. Close observation, info, support usually resulted in a gain by
3rd vss (3rd vss only given PRN).
I never wrote this up because I had a limited (skewed) population (moms who
needed vss on week ends) so it wasn't a cross rep of everyone seen in this
program. I also wasn't sure what effect my input as an IBCLC-LLLL-student
PNP had on the moms. And I really didn't have any way to measure this. I
just know what I saw. Would make a neat study. Do We Really Know What Is
Normal?
Merry Christmas to all who celebrate and Happy Holidays to everyone else.