Newborn baby being weighed on scale.

Is My Baby’s Weight Loss Normal Or Excessive?

The Newborn Weight Loss Tool can provide an answer.

Parents are taught that it’s normal for babies to lose 7–10% of their body weight in the first few days after birth, but is this true? Well, that depends. According to the AAP, a baby who loses more than 7% of his body weight may be losing excessive weight and requires a comprehensive lactation evaluation to rule out delayed onset of copious milk production, primary lactation failure, and/or infant oral anomalies that prevent adequate colostrum/milk transfer.

From the American Academy of Pediatrics HealthyChildren.org website. Breastfed newborns should lose no more than 7 percent of birth weight in the first few days after birth before starting to gain weight again. (Accessed July 16, 2020)

Weight loss has typically been assessed using simple percentages, but now there is a much more precise and accurate way to track excessive weight loss in newborns and many hospitals, pediatricians, and lactation consultants are adopting this method for greater accuracy in making clinical recommendations. The Newborn Weight Tool, or NEWT, is an online tool, the first of its kind, to help pediatricians determine whether exclusively breastfed newborns have lost too much weight in the first days of life. The tool was developed at Penn State College of Medicine through research conducted jointly with University of California, San Francisco. It was developed using a research sample of hourly birth weights from more than 100,000 breastfed newborns. For a quick synopsis of this tool from the lead investigator and one of developers of the tool, Dr. Ian Paul, watch the video below.

Source: Penn State Health News

In this video, Dr. Ian Paul, professor of pediatrics and public health sciences at Penn State College of Medicine and pediatrician at Penn State Hershey Children’s Hospital, talks about how NEWT fills an important void.  Determining whether an exclusively breastfed newborn is losing excessive weight is important because higher weight loss almost always reflects suboptimal milk intake. It is also associated with increased risk of medical complications such as low blood sugar, jaundice, and dehydration, which can result in the need for medical interventions and future health and developmental problems. This weight-loss tool shows that how quickly babies lose weight is just as important as how much they lose.

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Sister welcomes baby brother in heaven.

The Loss Of Our Son Has Devastated Our Family – This Time I Will Be Supplementing With Formula After Every Nursing session

I had a beautiful, healthy pregnancy with Bryson, with the help of Clomid (a fertility drug), like my first pregnancy with my daughter. After about 31 hours of induced labor, Bryson was here. Seven pounds, twelve ounces, and seemingly healthy! He latched like a champ immediately, and we had zero complications of any sort while in the hospital. He had wet and dirty diapers and was breastfeeding well, every 2–3 hours. His discharge weight was 7 lbs, and I had a follow-up appointment scheduled for two days later.

NEWT is the first tool that allows pediatric healthcare providers and parents to see how a newborn’s weight during the first days and weeks following childbirth compares with a large sample of newborns, which can help with early identification of weight loss and weight gain issues. Bryson was discharged with a weight loss of 9.7 percent at 36 hours of age. The NEWT graph indicates his weight loss was excessive.

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Baby with green pacifier.

The Loss Of Our Son Has Devastated Our Family – This Time I Will Be Supplementing With Formula After Every Nursing session

“Can I have a pacifier?” 

After helping a third-time mother latch her new baby, she requested the comfort tool she had used with her other two babies, whom she successfully breastfed until she went back to work and chose to wean. Our hospital policy is to educate patients on the many ways pacifiers can disrupt breastfeeding, rather than simply respecting the mother’s choice. The problems with this approach are twofold: there is recent good quality research showing pacifiers do not disrupt breastfeeding and actually reduce the risk of Sudden Infant Death Syndrome (SIDS). Even the WHO agrees—in 2018 they changed their Ten Steps to Successful Breastfeeding to reflect the fact that pacifiers are compatible with breastfeeding. 

Breastfeeding and pacifier use have a protective effect on sudden infant death syndrome

In responding to my patient, I had to choose between scientific evidence and maternal autonomy on the one hand, and our hospital protocol on the other. I chose to sneak her a pacifier at her request. To do otherwise would have been disrespectful towards this experienced mother, denying her autonomy over her baby and her body, and would have been contrary to my Code of Professional Conduct as an IBCLC, which emphasizes evidence-based practice. 

Cochran Review: Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding.

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Mom and baby on a beach.

Sacrificing Your Mental Health Is Not Worth It To Exclusively Breastfeed

Hopefully, my experiences will help another family avoid the psychological trauma that I endured while breastfeeding my daughter. This is what I learned:

  • Sacrificing your mental health or your baby’s health (or both!) to exclusively breastfeed is not worth it. 
  • Some breastfeeding advocates don’t see (or don’t want to see) the risks of exclusive breastfeeding which include a baby who isn’t gaining weight sufficiently, an emotionally suffering mum, or a strained mother–baby relationship.  
  • Seek help from lactation professionals who are open-minded enough to suggest combo-feeding as an option and are willing to support your choice because sometimes exclusive breastfeeding is not an option.

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Milk pouring; liquid courage concept.

Liquid Courage Sometimes Comes In The Form Of Baby Formula

Written by: Sarah L. R.

“I think it would be very courageous for you to do this.” 

My psychiatrist leaned forward in his chair, clasped his hands together, and smiled at me. 

Grabbing a tissue from the box on the table, I sniffed, “Then why do I feel like the biggest coward for making this decision?!” 

“Sarah, what’s braver than making sure you’re the best mother you can be?”

It took several more conversations and even more tissues, but eventually, I made the decision to forgo breastfeeding entirely, and feed my daughter formula milk from birth. In doing so, I hoped to avoid postpartum depression and anxiety that haunted my earlier experiences as a new mother. 

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