Abstract
ObjectiveTo determine the risk factors for weight loss over 8% in full-term newborns at postpartum discharge from a Baby Friendly Hospital. MethodsThe cases were selected from a cohort of infants belonging to a previous study. Healthy full-term newborns with birth weight ≥2.000g, who were exclusively breastfed were included and excluded twins and those undergoing phototherapy as well as those discharged after 96h of life. The analyzed maternal and neonatal variables were maternal age, parity, ethnicity, type of delivery, maternal diabetes, gender, gestational age and appropriate weight for age. Adjusted multiple and univariate Cox regression analyses were used, considering as significant p<0.05. ResultsWe studied 414 newborns, of whom 107 (25.8%) had excessive weight loss. Through the univariate regression, risk factors associated with weight loss>8% were cesarean delivery and older maternal age. At the adjusted multiple regression analysis, the model to explain the weight loss was cesarean delivery (Relative risk 2.27, 95% of Confidence Interval 1.54–3.35). ConclusionsThe independent predictor for weight loss>8% in exclusively breastfed full-term newborns in a Baby-Friendly Hospital was the cesarean delivery. It is possible to reduce the number of cesarean sections to minimize neonatal excessive weight loss and the resulting use of infant formula during the first week of life.
Highlights
Almost all newborns lose weight on the first days of life.[1]
In 20 newborns (4.8%) weight loss at discharge was higher than 10%
Hospital length of stay was significantly different between the groups with and without excessive weight loss; hospital discharge occurred, respectively, after 61.4±9.9h vs. 58.0±9.8h (p=0.003)
Summary
Almost all newborns lose weight on the first days of life.[1] Given this high frequency, the authors call it physiological weight loss.[2] Most studies suggest that the loss corresponds mainly to fluid reduction,[1] but it is a consequence of the use of adipose tissue as a source of energy by the newborns.[2]. On the first 2---3 days of life,[3] newborns that are exclusively breastfed lose on average between 5% and 7% of their birth weight.[1] The maximum physiological limits of weight loss for newborns that are exclusively breastfed are controversial. A weight loss of 10% can be considered normal or acceptable,4---6 there have been references about 7% values.[7]
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