It's normal for babies to lose weight after birth.
Conflicting opinions exist, however, with regards to up to what percentage of weight loss is normal and about when supplementation may be necessary.
Here are 6 things you need to know about newborn weight loss and what is ‘normal’:
#1: It's Important Not To Compare Apples With Oranges
When determining what is normal, it's important to keep in mind that breastfeeding is the biologically normal way to feed babies. Hence, what healthy, full term, exclusively breastfed babies do must be the benchmark we use. Else the control to which babies who are not exclusively breastfed becomes the comparative norm.
Therefore, deciding if a baby is losing too much weight after birth needs to be determined by taking into account what is normal for healthy, full term, exclusively breastfed babies, and not babies who are mixed fed or formula fed.
#2: It Takes Time For Your Milk To Come In
Around day 3 after a mother gives birth, her milk ‘comes in’ and she starts to make increasingly larger volumes of milk. Before this time, a baby drinks small amounts of colostrum frequently. Colostrum is a concentrated source of protein and anti-infective factors. It's all that is needed for a healthy term baby.
Babies have inbuilt ways to maintain their water, glucose and energy levels until large volumes of milk are available.
There's generally no need to worry about early weight loss. One your milk has come in and the volume of milk your baby drinks increases, he will keep gaining weight.
#3: Weight Loss Has A Range Of ‘Normal’
According to the Royal Women’s Hospital Clinical Guideline, ‘Breastfeeding the healthy term baby’:
“Loss of 7-10% of birth weight is normal in the first few days of life”.
Some have warned about the use of an absolute percentage that a baby can safely lose after birth. This is because an absolute percentage doesn’t take into account the normal range of percentages.
#4: Regaining Birth Weight
In terms of the time it takes babies to regain birth weight, the Academy of Breastfeeding Medicine clinical protocol #3 says:
“Optimally breastfed infants regain birth weight at an average of 8.3 days (7.7–8.9) with 97.5% having regained their birth weight by 21 days”.
#5: Intravenous Fluids In Labour Transfer To The Baby
Fluids given to a mother during labour cross the placenta to the unborn baby.
Many studies have shown that a baby’s birthweight can be artificially elevated due intravenous (IV) fluids given to the mother during labour.
This could make it seem like a baby is losing more weight than they are supposed to (and perhaps lead to unnecessary supplementation and a dent in the mother’s confidence in breastfeeding). And yet, all they may actually be losing is the excess fluid they have on board due to the IV fluids given to the mother during labour.
For this reason, it has been suggested that it may be better to weigh a baby at 24 hours after birth (when the excess fluid has been passed) rather than at birth.
This is important, since getting IV fluids during birth is very common these days. For example, IV fluids are given for:
- Labour induction
- Group B strep antibiotics
#6: IV Fluids May Cause Breast Swelling And Feeding Issues
In addition, the use of IV fluids during labour may result in generalised swelling, including of the breast. Any swelling of the breast affecting the areola and nipple can make it harder for a baby to attach to feed. Breast swelling may even contribute to a delay in a mother’s milk ‘coming in’.
Sometimes, excess newborn weight loss may be a sign of a baby not getting enough milk or an underlying medical condition. However, weight measurements should not be the only tool for assessing and making clinical decisions.
A complete evaluation is required, including assessing the baby’s output (poos and wees), oral anatomy, breastfeeding frequency and effectiveness etc.
It’s advisable that you seek an assessment from a healthcare professional if you have any concerns that your baby’s weight may be related to a health condition.