Ann writes,

> The doctor went on to say that a baby this age should be having 8 wet
> diapers a day.  I said that what the literature states the norm on the first
> day
> is one void and then just two voids on the second day.  She wouldn't hear me
> nor would she give me her reference.

Perhaps she needs to read Pediatric Clinics of North America, April 2001 --
excellent article by Linda Black.  Look specifically on page 302 which says:

"Urine output in the first 2 or 3 days reflects excretion of water and
electrolytes from an infant's extravascular-extracellular reserve. Urine output
gradually decreases as extravascular-extracellular fluid is depleted. Urine output
does not begin to increase until the volume of human milk intake displaces
the infant's need to use stored reserves. Therefore, urine output is expected to
gradually decrease over the first 2 or 3 days and then increase as the intake
of milk increases. For this reason, it is common for 3-day-old, breastfed
infants to urinate only once in the 24 hours before the mother's milk "comes in."
When an infant is appropriately breastfeeding and stage w lactogenesis occurs
normally, urine output should steadily and rapidly increase after the third
or fourth day postpartum to the stated three or four wet diapers per 24 hours,
and the urine should be pale and the diaper wet & heavy. A lower urine output
at 3 or 4 days of age is acceptable if the infant is feeding appropriately,
has moist mucous membranes and an acceptable weight, and the mother has definite
signs of increasing milk production....."

Jan Barger, RN, MA, IBCLC, RLC
Wheaton, Illinois
www.lactationeducationconsultants.com

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