Thanks so much Pat.I have read one of those articles. The JOGNN Mulder article examined the difference in breastfeeding frequency, voids, and stools in infants with weight loss < or >7% in the first 2 days postpartum. Some of the references in this article eluded to previous studies that drew conclusions re: maternal IV and infant weight loss. Population sample of 53.

Dahlenberg et al. 1980 ( one of the JOGNN references) has been provided to me as a reference more than once now however I don't believe this article (although I have not gotten my hands on it) is as related to current practices as some may imply. This article from Dahlenberg was published 30 years ago. This article refers to the use of a 5% dextrose IV solution resulting in maternal hyponatremia, a net transfer of water weight to the infant and a higher percentage (I don't know what that percentage is yet) weight loss in the infant after birth. As far as I am aware dextrose is no longer commonly used. The author's of the JOGNN article state, "...no research has been conducted regarding how a large intravenous fluid load of lactated ringers or normal saline or the administration of oxytocin may affect fetal fluid balance or newborn fluid loss, possible leading to excessive weight loss in the newborn during the first 2 days after birth."

The JHL article Factors Associated with Newborn In-Hospital Weight Loss: Comparison by Feeding Method, Demographics, and Birthing Procedures 2007, examined the factors associated with in-hospital postbirth weight loss of healthy, full-term newborns, including maternal and newborn demographics, birthing-related factors, and infant-feeding factors. This research was conducted by performing retrospective chart audits, with a population sample of 812. The factors associated with percentage of weight loss of the newborn included maternal epidural medication during labor and delivery which was associated with a newborn weight loss 0.5% greater than infants of mothers who did not receive epidural (and again, this weight loss was evaluated only in-hospital with a mean stay of 2.5 days). Not nearly the volume of weight loss I have read some imply will/can be associated with over hydration of the newborn due to maternal IV use during labor, nor the time frame I have most commonly read people imply this weight loss be attributed (days and sometimes within the first 2 weeks of hospital discharge). 

I'm curious about this topic and I would love to examine more references if anyone cares to share. I would also like to learn more about the mechanism of transfer of the maternal IV fluid to the fetus in utero.

I've had a few colleagues imply that it is the use of pitocin, which is an anti-diuretic, and commonly used with epidural anesthesia, that would transfer to the fetus, result in fluid retention of the fetus, and cause over hydrated weight at birth, resulting in excessive infant weight loss due to diuresis immediate postpartum. But I cannot find anything to support this claim either.

I'm certainly not drawing any conclusions just yet but I would love to read more literature on the topic. 

Thanks so much!

Michelle H. Kinne BA IBCLC RLC ICCE CD(DONA)


Date:    Tue, 4 May 2010 22:23:57 -0400
From:    Pat Young <[log in to unmask]>
Subject: Re: Infant weight loss and maternal IV



JOGNN 39, 15-26m 2010.  Excessive weight loss in breastfed infants during 
the postpartum hospitalization.  Mulder, P.J., Johnson, T.S & Baker L.C. 
Their conclusion was that weight loss greater than 10% might be physiologic, 
unrelated to their BF behaviors.

These 2 articles from the CBI Library are available thru your 
state/region/country LLLI APL.  Pat in SNJ 


 

 


 

 




             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome