Is it really a problem when a newborn loses nearly 10% of weight?

[Boot]

I am currently 37 weeks pregnant with my second and I'm trying to prepare for breastfeeding again. With my first we had a lot of problems that were eventually fully resolved but it was tough going. One of the problems was that he lost a lot of weight and was jaundiced and sleepy. My milk wasn't in yet and he couldn't latch on anyway so we ended up supplementing. Almost all my friends have had a similar experience. I actually warn pregnant women, 'don't worry if everyone starts panicking when your baby loses nearly 10% of birthweight. It will be fine' I can understand that the midwives and nurses are concerned for the baby but it seems such a common 'problem' that I wonder whether it is really a problem at all? Most people I know ended up supplementing with formula for about 24 hours and then going on to breastfeed exclusively but it seems a bit of a flaw in nature's design if so many babies really NEED this. If my baby loses close to the magic 10% by day 2 should I wait it out for a day or give formula to be on the 'safe side'?. This is assuming that this baby is able to latch successfully. What do you ladies think?

[new2texas]

From my experience it's pretty normal to lose up to 10% of birth weight. I don't agree with supplementing though, I think the baby should just nurse, nurse, nurse in those first couple days because that's what makes the milk come in. Most babies seem to be satisfied with colostrum for the first 24 to 48 hours which they need to help clear out the meconium.

[PatioGardener]

Important: The following assumes that mom did NOT have IV fluids in labour.

From my reading, 5-7% weight loss after birth is normal and expected. The WHO growth charts have this immediate loss built into them. Lowest weight is usually day 3 or 4 of life, then babies typically start to gain, reaching birthweight by 7-10 days of age.

IMO, a loss of up to 10% of birthweight is probably in the far end of normal, and as long as baby is latching well, nursing often and peeing and pooping well then I would not be worried.

A loss of over 10% may also be normal, but it also may not be, and is worth following these babies and mamas closely. Output needs to be measured carefully (diaper counts) to make sure that baby is not getting dehydrated. Is baby transfering milk well, or is there an issue like a tongue-tie that is preventing good latch/milk transfer? Is baby jaundiced and sleepy and therefore unable to latch and suck as needed? If so then maybe mama needs to hand express after each feed and refeed the colostrum/milk by syringe, cup or finger. Etc.

If baby was unable to latch well I'd hand express and / or pump and feed baby the colostrum as well as nursing. Colostrum is exactly what a newborn needs - great to get rid of meconium and help with jaundice. Personally I would avoid formula if at all possible if I had to supplement - going first with my expressed milk, second with donor milk and finally if neither of those were options I'd use formula.

[claddaghmom]

DD lost almost a pound. And then almost doubled the gain when my milk came in. I was not concerned.

[sdbeachy]

My son was 7 lbs 10 oz at (home)birth, and 6 lbs 10 oz when we took him to the doctor at 3 days old. They didn't seem overly concerned--suggested I supplement with formula AFTER nursing to see if he was still hungry, which I didn't do. 5 days later he was back up to birth weight, and perfectly healthy the whole time.

I later talked to a friend whose doctor freaked out because her baby lost 10% of her weight and it stressed her out so much her milk stopped! I had no idea about the 10% thing until then and realized that my son had lost more (does the math. . . ): 13%. He was fine.

[Llyra]

DD2 lost 18% of her weight in the first four days, before she started gaining. There were a number of factors at work-- multiple birth, c-section, birthweight on the low side, milk slow to come in (six days in that instance), a tad preterm, jaundice that went beyond the usual newborn jaundice my other kids had, etc. We didn't brush it off, definitely considered it problematic, and she did have a few ounces of formula on the fourth and fifth days, and we did use an SNS for a few weeks with pumped milk. But she started gaining it back as soon as I had milk, and was well over birthweight at two weeks old, and gained nicely after that with no supplementation at all (except for the odd pumped bottle when her twin was having health issues and needed me.)

What this taught me was that 10% of birthweight is hardly an emergency, if DD lost nearly twice that, and was still just fine with a little help. If I had a healthy, full-term baby, with a birthweight over 5 or 6 pounds, and a non-traumatic birth, and my milk came in within a normal time frame, I wouldn't resort to formula unless I was convinced baby was in real trouble.

And the magic number 10 wouldn't be enough to convince me. I would need to see concrete signs-- extreme lethargy, no urine output over an extended amount of time, other signs of dehydration, weight loss approaching 15 or 20%. Because I think you're right-- our bodies aren't that broken.

If so many babies "need" formula on the third or fourth day, then our criteria for judging who "needs" it must be what's broken. The clean virgin gut of a breastfed newborn is something we should try to protect, and formula compromises that, perhaps irrevocably. Formula also introduces the tricky issue of bottles. Not all babies are subject to nipple confusion, but when it does happen, it's difficult to overcome.

[AustinMom]

I highly recommend Dr. Jack Newman's ultimate breastfeeding book of answers.

I loved it and it really gives you hard evidence and advice from a professional. He is very anti-formula at any time in life. Maybe you could get some banked milk just in case and supplement with that, or if you know someone else bfing, ask them for an ounce or two of their milk. That's what I would do.

[Bokonon]

Originally Posted by PatioGardener

Important: The following assumes that mom did NOT have IV fluids in labour.

From my reading, 5-7% weight loss after birth is normal and expected. The WHO growth charts have this immediate loss built into them. Lowest weight is usually day 3 or 4 of life, then babies typically start to gain, reaching birthweight by 7-10 days of age.

IMO, a loss of up to 10% of birthweight is probably in the far end of normal, and as long as baby is latching well, nursing often and peeing and pooping well then I would not be worried.

A loss of over 10% may also be normal, but it also may not be, and is worth following these babies and mamas closely. Output needs to be measured carefully (diaper counts) to make sure that baby is not getting dehydrated. Is baby transfering milk well, or is there an issue like a tongue-tie that is preventing good latch/milk transfer? Is baby jaundiced and sleepy and therefore unable to latch and suck as needed? If so then maybe mama needs to hand express after each feed and refeed the colostrum/milk by syringe, cup or finger. Etc.

If baby was unable to latch well I'd hand express and / or pump and feed baby the colostrum as well as nursing. Colostrum is exactly what a newborn needs - great to get rid of meconium and help with jaundice. Personally I would avoid formula if at all possible if I had to supplement - going first with my expressed milk, second with donor milk and finally if neither of those were options I'd use formula.

It's also important to note that different scales can be off by several ounces, and even up to a pound. So if the first weight is taken at the hospital, and the next weight is taken at the pediatrician's office a few days later, you're not really comparing apples to apples.

[Boot]

Thanks for all your responses. It's confirmed what I was thinking. I've also asked a friend who used to be a LLL consultant. She's going to do some research for me. If this baby loses 'too much' weight I'd like to be able to offer some solid research to back up my mama instinct, (which is not to supplement if the latch and output is good).

Thanks for the book rec, I will see if our library has it. I will also look at donor milk. I have a friend who is nursing and would pump milk for me if needed I think but I don't know if she'd get much as her lo is older.

I did have IV fluids with DS so his birth weight was probably over inflated however he didn't gain any weight at all in his second week of life and took over 3 weeks to get back to 'birth weight' so there were a lot of serious factors at play there. I really hope we don't have to go through that roller coaster again.

[katelove]

In Australia we expect babies to lose up to 10% of their birth weight by about Day 3. We would not take any action on a loss that was 10% or less.

If they lose more than 10% we pay a bit more attention to their feeding and, in some circumstances, may advise 3rd hourly feeds, especially if the baby was fairly little to start with. The next step would be to supplement with EBM after each feed. Supplementation with formula would be *waaaay* down the track after everything else had failed and babe was still losing weight.

[ellasmomma]

Im a Lactation Consultant... I don't necessarily worry if baby has lost 7-10% of his/her birth weight.

If baby has lost 10% I just check on the latch/positioning and make sure everything looks good. I might do a follow up weight later, but losing 10% isn't in itself a reason to supplement.

[Qestia]

I think the 10% is a sign to keep an eye on the baby--the weightloss itself is not necessarily alarming, but combined with the jaundice and lethargy, yes, could be. Both my babies lost that or slightly more, but DS was born at 35 weeks, was jaundiced to the point of needed to be readmitted to the hospital, so the weight loss was more alarming--and with the lethargy we were unable to establish a good BFing relationship and I ended up quitting after only 5 weeks.

But DD was born one day shy of 37 wks, weighed 8lbs, was a super fast birth so my ped felt her weight loss was due to not getting the fluids squeezed out in the birth canal, and she had no jaundice problem. We had strouble nursing for about 12 hours--in fact I kept asking the nurses if we should supplement and they said "no!" and this was not considered a crunchy hospital! My girl didn't have a drop of formula until about 5.5 months old (and I WOH) and we're still nursing at 16 months with no plans to stop.

So, every baby is different!

[SallyN]

It depends on other circumstances. 10% weight loss with no other issues... probably not a problem. But something to keep an eye on.

I'm a fan of this: http://massbfc.org/index.php/2009/br...ng-management/

[Lil'Momma]

I have to agree with the PP, 10% in and of itself is not that big of a deal. My dd was born at 34 weeks and lost more than that and it wasn't until after 7 days when she wasn't gaining by that point that they brought up supplementing with EBM. They said they should start gaining again by a week old and reach Birth Weight by two weeks old, so at a mere three days... unless there were other serious signs of dehydration or such, I wouldn't worry or start supplementing.

I don't think mom's bodies are so broken that 90 something percent of them fail to provide enough milk for their babies in that first week or so. But then again, our society is so different from the way things were that who knows what has happened to the female body... j/k lol