I have had a number of breastfed newborns with excessive weight loss in the hospital lately and am trying to figure out why. Most of these infants have been otherwise healthy, no glaring red flags for breastfeeding trouble, and have had approximately 10% weight losses before turning around and gaining (or before weaning shortly after discharge which is pretty common around here.) I am trying to figure out what in our routine in the hospital can be causing this, and I think I've got it. Although we do a good job of encouraging immediate first feed, and frequently feeding during the day, many moms send their babies to nursery at night. Our nurses are good about not supplementing with formula, but they tend to take baby out to mom no more than every 3 hours, and only if they can't console them any other way. I know my own babies tended to be more wakeful and hungry the first few nights after birth than they were during the day. I'm thinking those frequent night feeds the first day our two are important to establishing milk supply and keeping babies from losing too much weight. I'm often faced with a sleepy newborn during the day who we have difficulty waking to latch, who is not gaining weight, and is spending the night in the nursery being consoled by a nurse instead of eating! The problem is, I'm the only one who seems to feel this way. The nurses see it as helping moms get some rest, and moms seem to feel they are entitled to this rest. Very few moms, even with urging will keep their babies at night here. Anyone have some good pearls on encouraging moms to keep their babies at night and feed frequently? Our unit doesn't bother moms about co-sleeping, so these babies could theoretically all be in bed with mom instead of in the nursery! I had a refreshing change this week, though. A gestational diabetic mom, who had a section for fetal distress, ended up with an SGA baby who weighed just 5 lbs 5 oz. Mom had large nipples, and despite baby having pretty good instincts, we had a hard time keeping her from sliding down to the base of the nipple where she seemed to not be able to move any milk. Mom was getting frustrated, and baby lost about 10% of body weight. This mom, though, was determined to make it work. She hung up a do not disturb sign and refused all visitors (she even stepped out in the hall and told several extended family members that showed up unannounced that she and the baby were tired and couldn't handle any visitors!) She called the nurses for help with latch every feeding, and kept the baby in bed with her the whole time. 24 hours later, the baby had a small gain and was nursing beautifully. And mom felt more confident and actually better rested. Now if I could get every mom to do that instead of wearing herself out with visitors and then struggling to care for the baby! Jennifer Tieman Family Physician Mom to 4, including nursling Caroline Rose born 5/31/03 *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html