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LACTNET  July 2011, Week 1

LACTNET July 2011, Week 1

Subject:

Re: weight loss in newborns

From:

Christine <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Tue, 5 Jul 2011 21:19:08 -0700

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (1 lines)

As Rachel so eloquently stated,  the focus on weight "loss" often puts lactation professionals in a difficult teaching situation. In addition to the list of factors she described, in our facility we find that we are often the only healthcare team members loof king back as far as labor and birth when considering these situations. When we listen to the birth stories from mothers of babies who are losing weight and whose bilirubin is rising,  and when we follow up by reading the charting of those births,  we hear almost exclusively tales of births which are far removed from normal. The interventions inevitably lead to slow starts on breastfeeding. Even "just an epidural " means extra IV fluid. We can't stress this enough and find ourselves constantly reminding staff and parents to reframe the situation so they can see why "breastfeeding isn't working. "  Their words,  not mine. Is it normal, they always ask. Common,  but not necessarily normal, in my humble opinion. 

LACTNET automatic digest system <[log in to unmask]> wrote:

>There are 3 messages totaling 183 lines in this issue.
>
>Topics of the day:
>
>  1. weight loss in newborn babies in first week
>  2. Woman defending her BF rights
>  3. Recurrent mastitis and homeopathy
>
>Lactnet Archives are at:
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>To Manage your Subscription, ie go nomail, index, etc, go to:
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>Thanks!
>
>LACTNET Facilitators
> Kathleen B. Bruce RN, BSN, IBCLC
> Rachel Myr, midwife, IBCLC
> Kathy Koch PhD
> Linda Pohl
> Karleen Gribble PhD
> Norma Ritter, IBCLC
> Nina Berry PhD
>
>Questions to [log in to unmask]
>
>             ***********************************************
>
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>
>----------------------------------------------------------------------
>
>Date:    Wed, 6 Jul 2011 01:36:38 +0200
>From:    Rachel Myr <[log in to unmask]>
>Subject: weight loss in newborn babies in first week
>
>Marla Newmark asks for references about this, and says 'We have MANY babies
>that loose greater than 5% of birth weight in the first 24-30 hours of
>life.  Then within the next 24 hours they loose an addition 3-4% making the
>total well over 8-9%.  And then of course the scenario goes that babies
>quickly get supplemented, parents panic that they are starving their baby,
>"no milk", etc.'
>
>I share Marla's frustration, because as we reduce the time mothers and
>babies are in hospital after birth, our discharge weights are now being done
>on day two or perhaps early on day three and, DOH; we are seeing more weight
>losses approaching ten per cent below birthweight.  This is not because more
>babies are losing too much weight.  It's because we are weighing them too
>early by at least 24 hours, sometimes 48.
>
>Isn't it odd that people doing the fearmongering about weight loss, and
>often setting policies and procedures for maternity units, are so CLUELESS
>about lactation phyisology?
>
>We know that the amount of colostrum secreted in the first 48 hours is
>small, and we know that newborns have stomach capacity for the amounts
>typically secreted by the breast in the first couple of days.  We know that
>it is almost never possible to produce transitional milk or mature milk with
>its higher water and lactose contents, until about 48 hours after giving
>birth.  And we know that babies empty their gut of meconium during that same
>48 hours.  In hospitals, it is considered 'frequent' if a baby feeds eight
>times in 24 hours.  In eight feeding encounters a baby doesn't have a chance
>to ingest as much colostrum as the amount of meconium and urine that come
>out.  It has been observed that when babies feed effectively and frequently
>right from birth, they sometimes do not have a recorded weight lower than
>their birthweights; rather they seem to gain right from the start.  How many
>babies born in your hospitals would be able to do that?  I know the answer
>is 'hardly any' in mine.
>
>We know that if the volume going OUT of the body exceeds the volume going
>IN, there will be weight loss.  The weight loss will continue unitl the
>volume IN exceeds the volume OUT.  It is unlikely that the usual events of
>the first few days of life are an example of poor design
>or absent-mindedness on the part of a Creator.  Volume IN exceeds volume
>OUT when lactogenesis II starts.  Why on earth would we expect a baby NOT to
>have lost this amount of weight?
>If a baby has unimpeded access to its mother and she knows enough to keep
>baby at breast, and baby is actively feeding and seems content and healthy,
>I'm not at all bothered by a ten per cent weight loss on day three.  I
>expect the baby to start gaining within 24 hours and unless the mother is
>scheduling feeds or is so sore that she is limiting feeding duration or
>freqency.  Soreness of that severity is a 'problem' in my book and I'd do my
>best to fix the problem.   Feeding formula is not normally part of my plans
>for how to fix breastfeeding.
>
>For the record, while I am comfortable with weight losses of ten percent on
>day two or three, I'm very concerned about five percent losses on day ten.
>I expect the baby to regain the lost weight about as quickly as it was lost
>and a baby who doesn't do that will need a closer look from someone
>knowledgeable about both babies and breastfeeding.  But what would the
>danger be in waiting until after babies are actually FEEDING before passing
>judgment on the quality or amount of the milk?
>
>We lack charts for this, unfortunately.  But the acceptable loss relative to
>birth weight changes from day to day in accordance with the phsyiology of
>lactation.  Too bad it is such a monumental task to teach health
>professionals why this is so.  Parents, on the other hand, seem to take the
>information in rather well.
>
>Good luck, Marla, and if you manage to get your point across where you work,
>I'll try to get my hospital to hire you to come and tell us about it.
>
>Rachel Myr, Kristiansand, Norway
>
>             ***********************************************
>
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>
>------------------------------
>
>Date:    Tue, 5 Jul 2011 20:57:11 -0400
>From:    Amanda Birkey <[log in to unmask]>
>Subject: Woman defending her BF rights
>
>A local woman was asked to cover up or nurse in the office while at a local baseball game. She stated it was her right to nurse where ever she wanted and the man rolled his eyes at her. So she asked to speak to someone about this. She got a manager, the owner of the ball park, and the man that approached her. They stated they did know the law but people had complained so they felt the need to say something. They then told her the conversation was over and she was dismissed. 
>This woman was the past chairperson of our local Breastfeeding Task Force so she is well aware of her rights and is an IBCLC. But at that moment she was angered and feels that she didn't come across in a way that will educate them or help them know how to handle future complaining patrons. This woman is also part of a very large parenting group that is calling/ demanding a nurse in. She is hurt by the rude treatment she received. She is asking for help in how to proceed. She wants the ball field employees to be educated on how to deal with complaints about moms nursing their babies. She has approached a local female news anchor- she stated the channel would cover a nurse-in. But sometimes nurse-ins have the opposite effect that we want them to.  
>
>What are some other ways to handle the situation?
>tuation and to offer them a free inservice from the local task force on how to handle complaints and to make sure they know what the law is. Task force even has those awesome window decals to have them show they support NIP. ;)
>
>So wise women from all walks of life, what would you do???  
>
>P.S- this happened on the 4th, you know the day we celebrate our freedom:)
>
>             ***********************************************
>
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>4. To get a comprehensive list of rules and directions: get lactnet welcome
>
>------------------------------
>
>Date:    Tue, 5 Jul 2011 21:49:27 -0500
>From:    Linda Anderegg <[log in to unmask]>
>Subject: Recurrent mastitis and homeopathy
>
>A mom called me on the warmline today with her second bout of mastitis.
>Baby is 6 weeks old.  She had a "perfect" breastfeeding experience with the
>first baby.  She had what she describes as an overactive letdown with the
>second, struggled to feed for 3 months, then pumped for another month.  She
>has had nipple pain, describing her nipples as very red or purple, the
>entire 6 weeks with this baby and frequent plugged ducts.  She feels she can
>take her time feeding even though she's busy with the two older children and
>has plenty of help.  She thinks she got mastitis the first time because she
>slept on her side, and feels she got the second bout because baby didn't
>drain both breasts at one feeding a few days ago.  My feeling is that there
>is a latch problem due to the nipple trauma and pain so asked her to drop in
>to assess the baby since she didn't have a Peds appointment for another 2
>1/2 weeks.  She was schedduled for the outpatient visit, then left me a
>message to cancel because she decided to call the Ped instead who told her
>to come in and she would give some homeopathic remedies.
> 
>Do any of you have any experience with homeopathy helping in this situation?
>I feel it won't solve the recurrent mastisis if the cause of the problem is
>not addressed as well.  I will call her just to follow up in 2 days. 
> 
>Linda Anderegg, BSN, RNC, IBCLC in Chicago 
> 
>
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>
>------------------------------
>
>End of LACTNET Digest - 5 Jul 2011 (#2011-544)
>**********************************************




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



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April 2008, Week 1
March 2008, Week 5
March 2008, Week 4
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December 2007, Week 5
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March 2007, Week 5
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January 2007, Week 1
December 2006, Week 5
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December 2006, Week 3
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December 2006, Week 1
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December 2005, Week 5
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December 2004, Week 5
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December 2004, Week 3
December 2004, Week 2
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November 2004, Week 5
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November 2004, Week 2
November 2004, Week 1
October 2004, Week 5
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October 2004, Week 3
October 2004, Week 2
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April 2004, Week 1
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March 2004, Week 3
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January 2004, Week 5
January 2004, Week 4
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January 2004, Week 1
December 2003, Week 5
December 2003, Week 4
December 2003, Week 3
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October 2003, Week 3
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August 2003, Week 5
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January 2003, Week 5
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December 2002, Week 5
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April 2002, Week 3
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March 2002, Week 3
March 2002, Week 2
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February 2002, Week 4
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February 2002, Week 1
January 2002, Week 5
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February 2001, Week 2
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January 2001, Week 4
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January 1999, Week 4
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December 1997, Week 5
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December 1996, Week 5
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