Question

The practical nurse obtains a weight of 3450g for Sandu. Mrs. Wasson is concerned about the weight loss, telling the practical nurse that she is probably not producing enough milk. What would be the best response by the practical nurse?

a) "This weight loss is normal in the first week. Continue breastfeeding at frequent intervals."
b) "Although most newborns lose weight in the first week, you should probably supplement him with formula for the next few days."
c) "This is not a significant weight loss, so don't be concerned."
d) "To prevent further weight loss, you can increase your milk supply by drinking more liquids during the day."

Answer 1

The best response is to reassure Mrs. Wasson that the weight loss is normal for the first week and to continue breastfeeding frequently, as weight loss of three to seven percent postpartum is expected, and milk production will adapt to the baby's needs.

Step-by-step explanation:

When considering the weight of a newborn like Sandu who has experienced weight loss, it is essential to understand that a certain degree of weight loss is considered normal in the first week postpartum.

Generally, neonates may lose about three to seven percent of their birth weight due to the resorption and urination of fluid, and slight delays in establishing a consistent feeding routine. A healthy neonate should start to gain weight after this initial period, typically at a rate of up to 20 g (0.7 oz) per day.

Regarding Mrs. Wasson's concern, the practical nurse's best response would be:
a) "This weight loss is normal in the first week. Continue breastfeeding at frequent intervals." This reassurance is based on the understanding that weight loss within this range is expected and does not immediately suggest that Mrs. Wasson is not producing enough milk.

Moreover, the milk supply will adjust over time to meet the infant's demand, and frequent breastfeeding can help maintain and increase the milk supply due to the prolactin-mediated synthesis of milk.

For optimal neonatal health, monitoring weight and growth is a regular part of pediatric care. Significant weight changes, especially a five percent weight loss during weeks three and four postpartum, would be more concerning and warrant further evaluation.