Abstract
BackgroundNewborn weight measurements are used as a key indicator of breastfeeding adequacy. The purpose of this study was to explore non-feeding factors that might be related to newborn weight loss. The relationship between the intravenous fluids women receive during parturition (the act of giving birth, including time in labour or prior to a caesarean section) and their newborn's weight loss during the first 72 hours postpartum was the primary interest.MethodsIn this observational cohort study, we collected data about maternal oral and IV fluids during labour or before a caesarean section. Participants (n = 109) weighed their newborns every 12 hours for the first three days then daily to Day 14, and they weighed neonatal output (voids and stools) for three days.ResultsAt 60 hours (nadir), mean newborn weight loss was 6.57% (SD 2.51; n = 96, range 1.83-13.06%). When groups, based on maternal fluids, were compared (≤1200 mls [n = 21] versus > 1200 [n = 53]), newborns lost 5.51% versus 6.93% (p = 0.03), respectively. For the first 24 hours, bivariate analyses show positive relationships between a) neonatal output and percentage of newborn weight lost (r(96) = 0.493, p < 0.001); and b) maternal IV fluids (final 2 hours) and neonatal output (r(42) = 0.383, p = 0.012). At 72 hours, there was a positive correlation between grams of weight lost and all maternal fluids (r(75) = 0.309, p = 0.007).ConclusionsTiming and amounts of maternal IV fluids appear correlated to neonatal output and newborn weight loss. Neonates appear to experience diuresis and correct their fluid status in the first 24 hours. We recommend a measurement at 24 hours, instead of birth weight, for baseline when assessing weight change. Because practices can differ between maternity settings, we further suggest that clinicians should collect and analyze data from dyads in their care to determine an optimal baseline measurement.
Highlights
Newborn weight measurements are used as a key indicator of breastfeeding adequacy
A planned caesarean section, fetal decelerations before birth, and an epidural in labour often have something in common: boluses of maternal intravenous fluids administered before birth [1,2,3]
Some patterns for weight loss appear in the literature, there is a lack of evidence to explain the variation in early newborn weight loss and a lack of indicators for morbidity and mortality related to a percentage of weight lost during the first two weeks postpartum [8]
Summary
The purpose of this study was to explore non-feeding factors that might be related to newborn weight loss. A planned caesarean section, fetal decelerations before birth, and an epidural in labour often have something in common: boluses of maternal intravenous fluids administered before birth [1,2,3]. This extra maternal fluid raises a question about how the unborn neonate is affected and whether the ensuing post-birth newborn weight loss is related to a fluid shift rather than feeding or pathology. Weight loss patterns are used as the basis for clinical decisions about infant feeding
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