The recent posts regarding infant weight loss following birth brought out a question about the relationship between this and the use of intravenous fluids during labor. I found a review article on this topic: Keppler AB: The use of intravenoous fluids during labor. Birth 1988; 15:75-79. While there are probably newer ones on the same topic, I found it of interest that the article mentioned a study done in 1980 which showed a large fluid shift from mother to fetus when D5W was used as the IV solution. In the first 48 hours, babies of moms who had glucose IVs lost 6.17 (plus or minus 3.36)% of their birthweight compared with babies whose mothers had only oral fluids. They lost 4.07 (plus or minus 2.20)% of their birthweight. The review article also mentioned that when large amounts of lactated ringer's solution is used, there is an increased possibility of large fluid shifts from mom to baby. When hyponatremia (low sodium) was induced in women there was a net transfer of water to the fetus. This influences the birth weight which then is not a true reflection of the baby's real weight. It influences weight checks the first week and could contribute to early unnecessary supplementation and false reporting of perceived insufficient milk production. The increasing use of epidural analgesia with its accompanying side effects (IVs, maternal fevers) and use of IV fluids is one more intervention that we take into account during assessments for breastfeeding problems. I like the conclusion of the Keppler article. She states,"Although giving the correct solution in the correct amounts may avoid the problems of maternal and neonatal hyponatremia, maternal and fetal hyperglycemia, neonatal hypoglycemia, and fluid overloading of mother and infant, the routine use of IV fluids for all laboring women is unnecessary and often unwise."