Weight Loss in Infants May Be Due To Birth Story: Dr. Jack Newman’s Perspective

One of the main reasons new mother’s are referred to me from their pediatrician is due to increased weight loss after birth. I expect a 7% weight loss, that is normal, and there is no need for intervention.  As long as the baby is back to birth weight by 2 weeks, we know that the baby is getting enough milk. However if a baby has lost 10% of his birth weight after delivery pediatricians begin to get concerned and often begin wanting some form of intervention. Recently the Journal of Human Lactation posted an article based off of a research study done to prove how birth practices do in fact effect the initial birth weight of the baby, and if the mother has had an induction, a cesarean birth, or an epidural longer then 6 hours, the additional fluids passed into her will in turn get passed into the baby, thus resulting in a “false” birth weight. It was recommended that in this case a baby should be weighed 24 hours post delivery to truly decide the actual birth weight. For further explanation, here is a recent post Dr. Jack Newman placed on Facebook, and has allowed me to use with permission. Dr. Jack Newman, is one of the most brilliant minds of our era. Not only is he a fantastic pediatrician, he also is a lactation expert and breastfeeding advocate. Here in his own words is his perspective on infant weight loss after birth:

So maybe now it’s time to talk about percent weight loss. In many, if not most postpartum areas in North America, someone has come up with the notion that 10% weight loss (7% in some places) means the baby is dehydrated and needs to be supplemented. This number (or these numbers) come out of nowhere with no evidence to back them up. And percent weight loss actually means nothing at all. Why?

1. Most mothers in North America receive intravenous fluids during the labor and birth and often receive quite large volumes. Some of that fluid goes over to the baby and so babies are born “overhydrated” and “extra heavy”. They start to pee out that fluid in the hours after birth and so “lose weight” which is not true weight loss. This is not taken into consideration when one talks about percent weight loss. Two recent studies show this to be true.

2. Scales are not the word of God. First of all, when one weighs a baby on one scale and then on another, one cannot compare the two weights. Scales often differ considerably one from the other. I have personally seen one scale (the accurate one) weigh 400 grams (about 12 ounces) more than the other scale which was off. This is dramatic and probably does not happen often, but 80 grams (almost 3 ounces) is not rare and I have seen two scales, made by the same company, same model, sitting one beside the other weigh the same baby but with an 85 grams difference. Let’s make the math easy: 90 grams for a baby born at 3000 grams (about 6lb 10oz) is 3%. So if a baby is weighed on the first scale and then on the second scale which weighs lighter, he automatically has lost 3% of his birth weight. Babies are often weighed on one scale in delivery and another in postpartum.

3. Furthermore, weights are often read wrong and written down incorrectly especially in busy maternity wards.

However, there is a concern. Women in labor who receive large amounts of fluids will often be quite swollen, not only their ankles and fingers, but also their nipples and areolas which makes it difficult for the baby to latch on and therefore the baby may not be getting milk well.

Unfortunately, the approach in most postpartum areas is to give formula, usually by bottle. This is completely the wrong approach. The mother and baby should be helped with breastfeeding. Again, the mother and baby should be helped with breastfeeding!”

Well stated Dr. Newman! To quote him again, if their is a weight loss, our first goal is to feed the baby preferred with expressed milk and if necessary formula, but the true solution is to help the mother and baby learn to breastfeed correctly! If you and your baby are currently dealing with a significant weight loss, consult with a International Board Certified Lactation Consultant to help find a plan that works best for the both of you.

For more information on Dr. Jack Newman, MD visit his website at: http://www.breastfeedinginc.ca/content.php?pagename=drjack

Copyright© 2013 Danielle Gauss,IBCLC,ICCE/ JustBreastFeeding.com. All Rights Reserved

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