Micaela Notarangelo, PhD, IBCLC, RLC, obtained her IBCLC certification in 2010. She has a private lactation consultant practice in Lerici, Italy and takes a particular interest in everything that concerns breastfeeding science and medicine. From 1992 to 2001, Micaela lived in Japan, where in 1998 she earned a PhD in Economics at Hokkaido University, Sapporo. She also worked as assistant professor at Hokkaido University and Utrecht University. After returning to Italy, she became a La Leche League Leader in 2005 and was the Area Professional Liaison of LLL Italy from 2010 to 2013. In 2017, together with Chiara Toti, IBCLC, Micaela has developed a new two-day course for health care providers about breastfeeding support for babies with lip and/or palate cleft. The course has been held, with the financial support of Aismel, a parents' association, in several major Italian hospitals.
There is increasing concern for the risk of hypernatremic dehydration (HD) in infants breastfeeding poorly, and weight loss (WL) is often considered a key variable in deciding whether to supplement a newborn. However, WL is the net sum of different forces, and it might be difficult to determine which actions will be the most effective in protecting both the baby and breastfeeding. This presentation will review the newest scientific evidence about WL, and by a comparison of the results of previous quantitative studies will provide a more comprehensive framework to interpret weight changes and feeding behaviors that can be suggestive of an increased risk of HD, in order to facilitate the detection of infants who can benefit from additional breastfeeding support and those who might eventually require supplementation. The data confirm that both birth and breastfeeding perinatal practices have influence on WL and the risk of HD, and are therefore important modifiable factors to improve breastfeeding outcomes.
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