Kathleen, I would add to your list the insensible fluid loss caused by warming lights. It is so common to bake babies (when they could be next to the warmest surface in the room: their mum!). Has a study ever been done of fluid loss per minute under these warmers? I think that some babies are so dried out by the warmers that it becomes impossible for them to rehydrate on colostrum; then a cycle is started--because calorie intake falls, baby nurses poorly... How many babies nurse poorly because of sore palates from bulb syringes? Have you watched how roughly babies are suctioned? I liken it to my own mouth when I rashly bite into hot hot hot pizza--its a few days before I enjoy eating. (And I probably lose a few ounces during those days--pity it makes so little difference on my frame!) Why are babies routinely suctioned, anyway? Are we humans not born with fully functional CNS? (barring heavy meds, that is). Margery Wilson, IBCLC Massachusetts Institute of Technology Medical Department Cambridge, Massachusetts, USA [log in to unmask]