Infant with Loss of 10% Birth Weight

Rationale

A term infant is born with a protective store of fluid, electrolytes and calories to protect him/her during the first several days of the establishment of copious milk production, which occurs around 72 hours post partum (somewhat earlier for a mother who has previously breastfed and later for the primiparous mother).

It is normal for term infants to loose up to 7% of their birth weight before regaining it by day 10. Though not equivalent to “10% dehydration”, a 10% of birth weight loss warrants attention. For a near-term baby, measures should be taken earlier (See Infants Born <38 Weeks Gestation or < 6 lbs)

Suggested Measures

Until infant is consistently having several liquidy bright yellow stools per day:

  1. Breastfeed at least 8 times/day and limit to 30 minutes.
  2. Supplement liberally with expressed breastmilk and/or formula to satiety after each breastfeeding.
  3. Pump and hand express milk at least 8 times per day.
  4. Follow up daily. Alert parents that several bright, yellow stools per day should be expected.

Suggested Script

Some babies jump the gun and temporarily need a bit more fluid until your milk comes in. The best way to make sure everything eventually goes well is have three messengers (your baby, your hands and your pump) send signals to your breast to bring in your milk. At the same time, we will give your baby the advantage of a little extra fluid and calories, so she/he will be vigorous at the breast.

Once your production is up, we won’t need to supplement.