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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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.

The first two days at home were easy. He was a sleepier baby than my daughter was, and unless wet or hungry, he was calm. I continued to breastfeed him for 20 minutes every three hours as instructed. I did begin to notice that his newborn onesie seemed quite big on him. His wet diapers did slow down on the third day, and he hadn’t pooped since the third day either. At two in the morning on July 29th, at four days postpartum, I tried to breastfeed again, but he was just too sleepy to nurse, and he would not latch no matter how hard I tried. I tried so many times, different ways, different positions. I thought he would eventually latch but he just wanted to sleep. I thought, well I can’t force-feed him, so I’ll try again after he rests a little more. I tried several times after that, and he was just less and less interested.  He had started to get pale and lethargic. It was also the day of his two-day post discharge checkup at the hospital, so I decided to take him in early, since I was getting concerned. 

During the whole drive there, I felt in my heart that time was of the essence. After the nurse checked him, she said he would have to be admitted, as he didn’t look too good, and his weight had dropped to 6 lbs 9 oz; he had lost over a pound in the four days since his birth. She turned her back, and I noticed he stopped moving. I hesitantly asked, “Is he breathing?” She turned around and yelled, “no!” then fumbled and fumbled to open a plastic bag; I finally screamed at her: “do something!” She picked him up and ran him down the hall. 

Bryson’s weight loss was 22 percent.

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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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Why I support #FedIsBest And Safe Sleep Practices As A Breastfeeding Mother Of Twins

 

In October of 2017, I was skimming Facebook and came across a question in one of my favorite Infant Safe Sleep support groups.  A new mother was having a hard time with breastfeeding and was looking for an evidence-based breastfeeding group that supported safe sleep for infants. When she got very little feedback, I began to think about creating a Facebook support group for safe sleep practices and breastfeeding because I knew there were plenty of mothers who wanted to exclusively breastfeed while practicing safe sleep.

As a mother of exclusively breastfed twin girls, I practiced the ABCs of safe sleep according to the American Academy of Pediatrics, and I felt confident that I could provide current evidence-based resources while providing practical tips and support, but the only real experience I had with breastfeeding was with my twins. I began to search for like-minded group moderators who wanted to help compile up-to-date scientific resources for which we called Breastfeeding Without Bedsharing & Evidence-Based Feeding.

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Nurses Talk About Delivering, Feeding, And Caring For Babies Following The AAP Guidelines When A Mother Is infected With The COVID-19 Virus

 

We know everyone’s anxiety level is very high right now because of the uncertainly of delivering your baby during the COVID-19 pandemic. Our goal is to provide real-life experiences of nurses who are taking care of people in labor and postpartum so that parents can have an idea of what to expect when delivering their babies.

The most recent guidelines released by the AAP, CDC, and ACOG apply to babies in the U.S.A.

Since these guidelines are different from the WHO guidelines and parents have been receiving mixed messages and are asking for clarification. We want to clarify the recommendations for parents so they can be fully informed of their choices. Generally speaking, parents who live in developed countries such as the USA have access to breast pumps, clean water, masks, cleaning supplies, and formula. The science-based recommendations are based on these choices.

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Hospital Drops Baby-Friendly Program After Doctor’s Baby Was Harmed

Written by an anesthesiologist and Intensivist physician

“The biggest achievement of my life as a physician was stopping my hospital’s Baby-Friendly program after my child was harmed.”

It was September 20th, and we were headed to the hospital for my induction.  I was nervous, as any first-time mother would be. I was worried that I was doing the wrong thing, even though I knew the literature, and my physicians supported my decision for an elective induction at 40 weeks. I was already dilated to 4 cm and my baby had dropped way back at 33 weeks.  We all thought it would take just a hint of Pitocin, but I labored for 24 hours until my son was born. I was later told that he was born with a compound hand (up by his head), causing the prolonged pushing time and his distress with each contraction.

While pregnant, I had decided to attempt breastfeeding, even though I had had a breast reduction in 2003. I tried to read as much as I could, but honestly, I didn’t have any idea how much information one needed to do something that everyone swore was “best” and “natural.”  My baby was born at 4:14 a.m. I thought this would be ideal, because I would have the support and help as I learned how to be a mother, knowing more staff were available during the day.  As the first day melted into the first night, nursing became more and more painful, and he needed to feed almost continuously. When he wasn’t feeding, he was either rooting or screaming.   Continue reading

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Will Breast Milk Protect My Baby From Getting Sick? Passive Immunity 101

Written by Jody Segrave-Daly MS, RN, IBCLC

As a veteran neonatal nurse and lactation consultant, I am often asked by parents to explain how the antibodies found in breastmilk work to protect their babies. Published research on immunology is extremely technical and difficult to understand, and unfortunately, the information that is readily available (especially on social media) contains a lot of false and conflicting information. So I’m here to share evidence-based information about this very important topic in a way that is easier for most parents to understand.

How does the immune system work?

Our immune system is very complex, but generally speaking, it is responsible for fighting off both germs that enter our bodies from our environment, and also for protecting us from diseases like cancer that occur within our bodies. I will be focusing on how the immune system fights off germs, which it does by producing antibodies.

What is an antibody and what does it do?

An antibody is a protein that is produced by the body’s immune system when it detects the surfaces of foreign and potentially harmful substances, also known as pathogens. Examples of pathogens are bacteria, fungi, and viruses, which are all microorganisms. The antibody response is specific; it will seek out and neutralize the microorganism and stop the invasion. There are five classes of antibodies: IgM, IgG, IgA, IgD, and IgE.

There are two ways babies acquire and develop immunity:
  • The first way is through passive immunity (temporary)
  • The second way is through active or acquired immunity (lifelong) 

Note: Antibody types and where they are acquired from are denoted by color throughout the blog.

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Baby-Friendly USA Acknowledges Their Mistakes; Are They Going To Make Real Changes In The New Year Or Are They Providing Lip Service To Mothers?

Dear BFUSA,

Thank you for your long-overdue public acknowledgment endorsing what the Fed Is Best Foundation has been fiercely advocating for over the past 3 years. 

According to your recent blog post you now agree with us that:

1. Delayed onset of copious milk production is common. 

BFUSA: “Delayed lactogenesis is actually increasingly common because the risk factors for it are potentially increasing,” Dr. Rosen-Carole says. “When a baby is born into that situation, the goal is to closely monitor what the baby is doing, instead of giving a bottle right away. “If the baby is hungry and they’re not getting enough milk out of the mother’s breast, then they need to be supplemented,” she says. 

FIBF: We have been passionately educating parents about safe breastfeeding since the beginning of our advocacy over 3 years ago with the current scientific studies that have confirmed over and over again that delayed onset of milk production and low milk supply are common.  We question why it took you so long to acknowledge this deadly and 100% preventable consequence of insufficient breastfeeding? Does this mean you will ban the belly bead stomach models that do not reflect the current science?

Will you please apologize to the thousands of mothers who bravely told their stories of accidental starvation?  You have previously tried to discredit their stories, called them “‘anxiety-provoking,” and characterized our foundation as BFHI detractors— simply because we offer a social media platform for mothers to be heard by you. Have you ever heard a mother break down and scream in horror when she learned her baby was starving to death because she followed your breastfeeding education and protocol?  We have—over and over again, and it is the most haunting sound. It’s what drives us to fiercely advocate for safe breastfeeding because no other health organization is doing so.

BFUSA: Dr. Bobbi Philipp agrees. “If you see signs that the mother’s milk is insufficient, you need to feed the baby,” she says. “And if the mother is really committed to breastfeeding, you’ve got to bridge the gap in a way that you support her, feed the baby, and don’t undermine the breastfeeding. It’s that simple.”

FIBF: Now that you are acknowledging delayed onset of milk is common, something that we have been passionately writing and speaking about for years, we expect that you will stop calling us “fibbers.” Name-calling is what a child having a temper tantrum does, not what a professional organization should do; the appropriate response to being called out and held accountably, is to take responsibility and revise your guidelines based on current research and patient feedback. Continue reading

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Dear Parents, Did You Know Just 2 Teaspoons Of Supplementation Can Protect Your Baby And Your Breastfeeding Journey?*

Written by: The Fed Is Best Foundation IBCLC Team

There have now been six studies showing that in some infants, a little bit of supplementation with two teaspoons (10 mL) of formula or donor breast milk after nursing had no effect on long-term breastfeeding. One study showed it prevented hospital readmissions in all of the supplemented newborns. Another showed it actually helped breastfeeding! 

Why aren’t medical and lactation professionals recommending this intervention?

Many medical and lactation professionals believe that a tiny amount of formula will contaminate the baby’s gut, causing lifelong health problems. They refuse to admit that formula supplementation can be helpful, and they have baseless concerns that temporary formula supplementation will become routine for all babies.  According to Baby-Friendly USA, “donor [breast] milk takes the fight out of this.” What they mean is that the few babies who are born in a hospital with donor milk can be fully fed, while the vast majority of babies who are born in hospitals without donor milk just have to tolerate hunger and thirst so as to avoid a few teaspoons of formula.  

Did you know two teaspoons of formula or donor milk has seven calories?  

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Baby-Friendly: Failure and the Art of Misdirection

By Alex Fischer, PhD Candidate, Brooke Orosz, PhD, Jody Segrave-Daly, RN, IBCLC and Christie Del Castillo-Hegyi, M.D.

Any good magician will tell you that the secret to their trade is misdirection—making the audience look one way while doing something the other way. And even knowing this, most of us are still baffled by a magician’s tricks. So it’s no wonder that Baby-Friendly USA (BFUSA) has tried to employ that same tactic in their statement titled “Fact vs FIB: The Impact of Baby-Friendly on Breastfeeding Initiation Rates.”  In this statement written by an anonymous author representing BFUSA, they attempt to dispute the findings of a recent study published in Journal of Pediatrics, “Outcomes from the Centers for Disease Control and Prevention 2018 Breastfeeding Report Card: Public Policy Implications” by Bass et al. This study examines the impact of statewide breastfeeding initiation rates as well as the impact of BFHI facilities on continued breastfeeding after hospital discharge (exclusive or combination). The Fed is Best Foundation read this study and agreed: “Baby-Friendly does not work.” These five words are the instigators of the entire statement by BFUSA and its misrepresentation of a very robust scientific study.  Continue reading

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