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My baby is losing weight. Now what?

It is very common for babies to lose some weight (usually less than 7% of their birth weight) after their birth. Birth weights can be inflated slightly sometimes due to IV fluids but sometimes weight loss greater than 7% of the birth weight is due to insufficient milk transfer, sleepy babies (drugs, prolonged labor and pushing phases), oral issues in the baby (tight oral tethers, low tone, hyper tone, clefts), breastfeeding management issues (strict feeding schedules, limiting time at the breast, offering only one breast, allowing baby to sleep many consecutive hours many times a day – missing feeding cues/opportunities), etc.

If your baby is seen by a pediatrician a few days after your hospital discharge or home or birth center birth, keep in mind the baby has been weighed on different scales each weight (birth, 24 hours, discharge, etc) and there may have been initial overhydration/weight inflation due to IV fluids. If your baby has lost more than 7% of their birth weight it may be a good idea to call an IBCLC for a consult. When issues arise the sooner they are addressed the better for the nursing dyad. Prolonged weight loss can be a dangerous situation leading to dehydration, electrolyte imbalances, major jaundice issues or worse. Sometimes the baby’s output (urine/poo diapers) is enough of a clue to know that milk transfer is low – but that’s just one part of the puzzle. Keeping track of output the first week or two is a good idea in general. What happens at an IBCLC consult is much like what happens when an investigator is solving a mystery. Data is collected: medical history, birth history, lactation history, current medications/herb information, witnessing breastfeeding on each breast, watching the baby for cues (physical cues, sounds, latching, an oral exam to assess sucking, palate, tongue, etc). Once the IBCLC has a good “big picture” of the history and current goings on it’s time to create a care plan. Sometimes care plans have “Plan A” and “Plan B” (and Plan C) so that the parents have options and choices as they continue to gather their own data (weight checks at the pediatrician’s office, researching/deciding if they want to use formula, pumped milk or donor milk, what course of action they feel is necessary to keep the family’s babymooning running smoothly).

There can be so many whys and hows to a newborn’s weight loss it can be tricky to navigate alone. Often times parents are tossed a can or case of formula and sent on their way without anyone assessing the baby, the breastfeeding, the mother, or any part of their lactation issues. IBCLCs can help parents navigate the waters as their baby is under the watchful eye of the pediatrician for positive weight gain. Ideally babies will return to birthweight within the second week of life (gaining 6-7 oz per week on average).

If you face concerns about lack of weight gain or major weight loss within the first week of life it is best to reach out to a clinical lactation care provider to help assess the situation and make recommendations based on your specific circumstances.

If you are in the Atlanta, Georgia area and are facing no or slow to gain challenges with your baby, please feel free to contact me for a consultation.

Best, Angela 678-432-7917

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