Level 1 Newborn Nursery-newborn Weight Checks

Hello! I am curious what other institutions do regarding checking newborn weights??? After delivery are weights done every shift, once a day, or only at discharge unless there have been concerns or problems that develop? If a newborn has a weight loss of 10% or greater do you have protocols for continuing the hospitalization or for f/u within 24-48 hours?

In the quest for more knowledge,

LCDebbie

[finallyRN]

We do weights once a day after delivery. Weight loss greater than 10% is brought to the attention of the pediatrician. It is then the doctors choice. If the baby is NOW feeding well and it isn't significantly greater than 10% then infant is usually sent home with f/u appointments in 24-48 hours. If the baby still is having feeding issues they will be kept in our NICU for observation.

Meghan

[OBNURSEHEATHER]

We also do weights once daily after delivery. As for a 10% weight loss, it is brought to the attention of the ped. Depending on the newborn's current feeding routine, the baby is either kept for closer monitoring or discharged home with a f/u appointmet usually in the next day or so. Again, it all depends on how the baby feeds and how confident the doc is witht he parents to report to the doc is changes or problems occur.

As for your question about Nubain, that is a good one. Does the Nubain make babies poor feeders? Or is it the epidural? Or is the the trauma of birth? Or is it the circumcision? Or is it........

There are so many variables that we throw into such a short hospital stay that I couldn't even venture to guess. But I'm interested to hear if anyone else has any comments or observations to share.

Heather

[LCDEBBIE]

Hello! Thanks for the insight so far. You will be surprised to know that our hospital does not do epidurals "at all" and spinal anesthesia only for c/s deliveries. Recent case of newborn: Female (so no circ) newborn, born via c/s with 12% weight loss on discharge; breastfeeding, mom's milk supply was coming in-milk transfer observed with proper coordination at breastfeeding, mom had at least 8 liters of IV fluid (maybe more) prior to delivery. I have been of the mindset that with such IV hydration that maybe another weight should be obtained at 12 hours of age or do weights every shift. Still looking for research studies etc on these subjects.

Yours in lactation,

LCDebbie

Sault Ste. Marie, MI.

[indynurse]

Over what period of time did she receive the 8 liters of IV fluid? Are you thinking it has somehow hemo-diluted the baby in utero? Or are you thinking this is somehow affecting Mom's milk production? I would be interested in seeing any research results you find.

We weigh each baby when we do midnight vitals and assessments on all babies. A weight loss of 10% or more is brought to the attention of peds. Peds will decide whether to keep the baby and lactation will observe a feeding prior to discharge. Most of our peds will bring a breastfeeding baby in for a "weight check" within the first week after discharge. Some peds will see a baby the day after discharge if the baby is near 10% weight loss the day of discharge. Lactation also calls all of our breastfeeding moms the day after discharge to see how things are going at home.