Any mom who has faced a breastfeeding challenge will tell you how traumatic it can be. Feeling like your body isn’t working – or that you are failing your baby in some way – cuts right to your core. In the end, whatever happens with breastfeeding, everything will work out just fine (promise!), and you are good mom, without a doubt. But in those moments when things are going haywire, it can be an emotionally devastating experience.
One of the top reasons for breastfeeding difficulties is the presumption – true or not – that your baby is not getting enough milk. When your baby is first born, you produce a milk called colostrum, which has everything your baby needs, but it only comes out in droplets at first. Most moms have their full supply “come in” a few days after birth – but even then, it can be hard to feel assured that your baby is really getting enough of it.
For seven years, I worked with breastfeeding moms (as a breastfeeding counselor and then lactation consultant), and I will tell you that one of the best gauges we have to measure whether your baby is getting enough milk is by checking their weight gain. It’s normal for newborns to lose a little weight in the first few days after birth (they have lot of peeing and pooping to do!), but within a few days, you want to see that the baby is starting to gain weight.
When they are not gaining weight – or worse yet, losing weight – everyone starts to get nervous. And in some cases, there is cause for alarm. Babies need to eat, for sure, and being irresponsible about making sure they are fed is a dangerous business indeed.
However, there are often cases (and I have seen quite a few) where the conclusion is drawn way too soon that a baby is not getting enough milk, and a baby is supplemented with formula before a mother has had a chance to establish breastfeeding. (To be clear: formula is not a problem if that is what a mother chooses to do, but for mothers who are determined to breastfeed exclusively, formula can decrease their milk supply.)
There are a lot of reasons why a baby would not be gaining weight – too many to go into here. However, there is one that is not very well known, but is a frequent cause of newborn weight loss. And because of it, mothers are often incorrectly told that their baby has lost too much weight and must be supplemented with formula.
Here’s the deal. You know how moms are frequently given IV fluids during labor? Well, it turns out that if you were given these fluids close to the time that you gave birth, your baby’s birthweight may have actually been inflated as a result of the excess fluid in utero.
That means that when your baby was weighed at birth, and that weight was compared to their weight just a few days later, it looked like they lost too much weight, when in reality they only lost those excess fluids they retained because of their mom’s IV.
A study in the International Breastfeeding Journal lays it all out. The researchers say that for the fluids to affect the baby in this way, they generally need to be given within about 2 hours before birth – and they indeed found that these babies birthweights were inflated.
Interestingly, within those first 24 hours, say the study authors, a baby will have lost all the excess fluids. And so their recommendation is that babies whose moms have IV fluids be weighed at the 24-hour mark rather than at birth to get a more accurate birth weight. This 24-hour weight can be then compared to their weight a few days later to determine if they are getting enough to eat.
The Academy of American Pediatrics (AAP) came to a similar conclusion in a study they released in 2010. They found the excess weight loss (EWL) for breastfed babies was often related to a mom’s IV fluid intake during labor.
“EWL was more common in this population than reported previously and was independently related to intrapartum fluid balance,” write the AAP. “This suggests that intrapartum fluid administration can cause fetal volume expansion and greater fluid loss after birth, although other mechanisms are possible.”
So what does this mean to the average breastfeeding mama?
Well, it’s important to know breastfeeding difficulties are usually a little complicated and often have more than one cause, so you can’t always point to one thing and say, “Oh, so that’s why!”
I definitely don’t recommend you self-diagnose, but anyone who is facing breastfeeding difficulties make an appointment with a lactation consultant or a call a volunteer breastfeeding counselor, like La Leche League.
That said, if you or someone you know has a baby who has lost too much weight and you are aware that you got IV fluids in the hours leading up to the birth, it’s definitely something you should bring up with your doctor or healthcare provider.
Some providers will already know to look into this factor (yay!), but unfortunately, not all are up to date, so it is worth bringing up. You can even show them the studies mentioned above to jump start the conversation.
Most of all, if you are experiencing any breastfeeding difficulties, please know that there is almost always a way to solve them, and there are great people out there willing and able to help you. And know, too, that breastfeeding success looks different for every mom out there, every drop counts – and whatever happens, you are a fantastic mama.