Tuesday, December 21, 2010
Two items hot off the presses this week. Which should I start with? The (somewhat) good news, you say?
First, some research just emerged which relates to both birth and breastfeeding. The impact of IV fluids - mother's intrapartum fluid balance - on a newborn's weight loss had been studied, and a connection was found between mother who received more than 200 ml per hour and newborns who lost an "excessive amount of weight" (up to 10 percent is normal and to be expected) in their first days. It turns out that, as many have suspected, babies can take in some of that excess IV fluid themselves.
How does this impact breastfeeding? Neonatal weight loss that is greater than the norm frequently prompts formula supplementation, when in fact feeding issues have nothing to do with the excessive drop in weight; baby is simply shedding the extra fluid. Early formula supplementation is a major booby trap, so it's good to have a solid basis for avoiding it whenever possible.
It's also worth noting that IV fluids often have a second significant impact on the new breastfeeding relationship: mothers who have received IV fluids can also become extremely engorged, beyond the normal fullness of mature milk 'coming in', making it (a) much more difficult for baby's little mouth to latch on, and poor latching can lead to both inefficient milk transfer and degrees of discomfort for the mom that range from irritating to excruciating; and (b) severe, if temporary, discomfort for the mother.
This is not to say that there isn't a place for IV fluids, when necessary. But though it may not be thought of as a serious intervention in the way that we think of, say, internal monitoring or episiotomies, it is still an intervention, and should be considered carefully, both pros and cons. We now have evidence of another significant con, and it should be factored into the decision-equation.
And, the bad news. Up from 2008's figures, the U.S. cesarean rate climbed once again, from 32.3% to 32.9%. Yup, that's a new all-time high, rising nonstop for 13 years running. Unnecessarean has all the news and blues about that over yonder, check it out to commiserate and lament.