IV Fluids Linked to Early Newborn Weight Loss

Most of us in the breastfeeding ‘biz’ have noticed an association of early newborn weight loss with an overload of IV fluids in mom’s system.  Now new research confirms this phenomenon.  Researchers in Canada have published their recent findings in The International Breastfeeding Journal.

According to the Morning Post Exchange:

“They found positive relationships both between the amount of IV fluids given to mothers before birth and neonatal output and between neonatal output and newborn weight loss during the first 24 hours following birth. At 60 hours post birth, the time of the lowest average weight, there was a positive relationship between the amount of maternal IV fluids and newborn weight loss.”

In layman’s terms that means the more IV-logged the mother, the ‘puffier’ the baby.  As the baby regulates its hydration, weight calibrates to what probably would have been its natural birth weight (usually at 24 hours, say the researchers).

Why is this important?  Because if a baby loses weight quickly in the first few days of life there can be a knee-jerk reaction for supplementation to offset weight loss. If clinicians can take this factor into account, baby and mom can be monitored and given time for things to resolve before resorting to unnecessary supplementation.

To compound things, many mothers are puffy themselves!  A mom who has had a long labor and several IVs will get even more IVs if she has a cesarean delivery.  She often will have swollen hands, legs and feet that take time to resolve (and also thought to lead to delay in increased milk volume).

Keeping baby skin to skin with ‘early and often’ feedings can usually keep things on track.  Another by-product is the tendency for IV fluids to cause areolar edema (fancy term for swelling of the tissue around the nipple).  Mothers can be taught to push back the tissue from the nipple base and to help with latch on.

A few years ago, Jean Cotterman was a guest lecturer at the hospital where I worked. She regaled us with examples of areolar edema and physiology and explained the technique she calls “reverse pressure softening.”

I teach this technique to new mothers and it never fails to enhance latch on and comfort for the mother.  It also stimulates the milk ejection reflex (commonly called the ‘let-down’ reflex).

Baby gets ‘liquid gold” and breastfeeding gets off to a better start.  With consideration of this evidence-based research, clinicians can now realistically assess newborn weight loss linked to IV overload and babies can continue to get the milk they deserve!

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