IV Fluids in Labor and Newborn Weight Loss
In my practice I see so many new parents struggle with breastfeeding. Newborn weight loss is a common issue that commonly leads to unwanted or unintended use of formula. Something that we view as simple and benign as IV fluids can actually lead to inaccurate weight measurements which can lead down the path of formula supplementation. An IV hydrates the birthing person and also the baby. So when they are born they are full of excess fluid compared to if they had not had an IV.
It’s normal for newborns to lose up to 7% of their body weight as the mother’s milk is coming in during those first few days. Up to 10% is acceptable by some pediatricians, however, when more than 10% is lost parents are often told they need to supplement with formula or pumped milk. And ideally, they will be back to their birth weight within two weeks. However if newborns are being tracked from birth with an artificially higher weight, they are more likely to lose that water weight and it will look as though they’ve lost more weight than they actually had.
Not only does an IV plump up the baby but it also plumps up breast tissue and that engorgement can make it harder for the baby to latch. Again leading to breastfeeding issues and a delay in milk coming in. Engorgement makes for tissue that is not as supple or malleable to fit into a newborn’s mouth and mold to their palate. It can often result in a more shallow latch which is not only painful but also can prevent the newborn from transferring as much milk as they could.
So if you do have an IV in labor, take the baby’s weight at 24 hours old and use that as your baseline so they have time to pee and release some of the excess fluid. This will give you a more accurate idea of how much weight they are actually losing if any.
Use baby’s weight at 24 hours old as their baseline
Also, the amount of fluid administered in labor has an effect on this. The more volume of fluid given the more likely you are to experience this artificial excess weight loss. Studies have found that mothers who receive 2,500 Mls or more are at higher risk for excess weight loss in their newborns. Evidence shows that hydration is essential in labor however drinking fluids is much more effective and doesn’t have the negative effect of newborn weight loss. Oral fluids have time to process through our digestive tract as opposed to an IV which goes right into the bloodstream.
So what’s the big deal with formula anyway? After all, fed is best right? Formula-fed babies are at higher risk of ear infections, asthma, diabetes, eczema, respiratory infections, digestion issues, and SIDS. So how can you avoid formula? The more your baby is latching directly on you the more you are to increase your milk supply. The Baby’s saliva is picked up by your nipple and your brain registers exactly what nutrients your baby needs in that very moment. It also increases oxytocin which is responsible for your let down. You can further increase oxytocin with skin-to-skin contact so if you need to be separated from your baby to pump try looking at photos or holding something like a hat or blanket that smells like them. If you are having trouble with latching, make sure to work with a lactation consultant and pediatric chiropractor. They can help you with positioning, oral, mechanical, or neurological restrictions and troubleshooting many other issues. If your nipples are cracked or damaged you might need to consider pumping or hand expressing to allow yourself time to heal. Pumping with simultaneous hand expression can significantly increase supply.
Milk donations from other lactating women are also a great alternative to formula. It also increases the number of antibodies to help fight potential infections because it exposes the infant to a whole new host of exposure from the milk donor’s environment. This is called informal milk donations. Milk banking is also another option. Milk from a milk bank has typically been screened for infections, however, it also goes through processes that decrease nutrient value. Just remember any time you give a bottle make sure to replace that feeding with pumping to keep your supply up. The more you empty your breast the more milk you will make. It’s all about demand and supply.
Formula-fed babies are at higher risk for ear infections, asthma, diabetes, eczema, respiratory infections, digestion issues, and SIDS
If your health care providers are recommending formula, please take this information into account. Work with a lactation consultant, pediatric chiropractor, or any other provider that will support you. Breastfeeding is HARD WORK. It doesn’t always come naturally and it’s not always easy. But the support is there. Build your team before you give birth so you’re ready. You’ve got this mama. And we’ve got your back!