Cheryl writes:
"The concept of baby being born super-hydrated from IV during labor doesn't
 not apply to my last two births with no IVs, but it is an explanation that
I  used with parents that are concerned with a baby that dropped more than
10% and  is nursing well and wetting well."

Here's what concerns me. How is "nursing and wetting well"  qualified and
quantified?

 I would much rather rely on the documentation of  suck/swallow ratio and
increasingly longer bursts of sucking with  swallowing appropriate to the
hours of age, and an  appropriate urine/stool output to agree that the baby is
nursing well. Also  has the baby been skin-to-skin for most of that time? In
my  experience, it is a RARE baby who loses more than 7-8% of birthweight
by 48-72 hours of age if he has stooled at least 2-3 times in the last  24+
hours, nursed 8-12 times, and urinated 2-3 (or more)  times,  is a fullterm
and healthy baby, has been s2s a lot, isn't using a pacifier,  and mother
does not have any underlying risk factors for delay lactogenesis, or
insufficient mammary tissue, or breast reduction. Many times the baby has  been "at
the breast" but not really nursing. Frequent documentation I see:  "Latched
well with a good latch, took a few sucks and came off several times."
H-mmm. Much more about the latch than the quality of the feeding.

Almost every mom I see has had an epidural or Stadol, often both, been
induced, has gotten IV fluids, and often Pitocin, baby has been passed around
to  many visitors, sometimes all of the above. It is rare for a mom to birth
normally. But I have seen babies who do nurse well, even with the many
interventions we see routinely, when the mom keeps them s2s and offers the
breast with feeding cues. These babies do not lose excessive weight. You  can
probably understand why many of the babies I see are not nursing all  that
well, and have weight loss greater than 7-8%. Rooming in, little  or no
pacifier use, and skin-to-skin is infrequent until someone realizes  that it's
been 24 hours or longer and the baby has not really latched and  suckled. We
have our work cut out for us.

Mary-Jane Sackett, RN, IBCLC, RLC
Hospital based LC
Pittsfield, MA

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