Abstract
Objective: To define the range of neonatal weight loss in a population relative to feeding method.
Design: Prospective observational cohort study.
Setting: Maternity service providing geographically defined, community based newborn follow up.
Participants: 971 consecutive term newborns of birth weight ⩾ 2500 g during the first 2–3 weeks of life; 34 excluded (inadequate data). 937 included: 45% breast fed, 42% formula fed, 13% breast and formula fed.
Outcome measures: Maximum weight loss and timing, age on regaining birth weight.
Results: Median weight loss: formula fed 3.5%, breast fed 6.6%. Upper centiles for maximum weight loss differ considerably (95th centiles: breast fed = 11.8%, formula fed = 8.4%; 97.5th centiles: breast fed = 12.8%, formula fed = 9.5%). Median time of maximum weight loss: 2.7 days for breast fed and formula fed. Recovery of birth weight: breast fed median 8.3 days, 95th centile 18.7 days, 97.5th centile 21.0 days; formula fed median 6.5 days, 95th centile 14.5 days, 97.5th centile 16.7 days. The time taken to regain birth weight correlates with both the degree and timing of initial weight loss for all groups.
Conclusions: Early neonatal weight loss is defined allowing identification of infants who merit closer assessment and support.
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Figure 1 .
Cumulative distribution curves for the breast and formula fed groups for (A) weight nadir, (B) maximum weight loss, and (C) time to regain birth weight.
Selected References
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- Clarke T. A., Markarian M., Griswold W., Mendoza S. Hypernatremic dehydration resulting from inadequate breast-feeding. Pediatrics. 1979 Jun;63(6):931–932. [PubMed] [Google Scholar]
- Cooper W. O., Atherton H. D., Kahana M., Kotagal U. R. Increased incidence of severe breastfeeding malnutrition and hypernatremia in a metropolitan area. Pediatrics. 1995 Nov;96(5 Pt 1):957–960. [PubMed] [Google Scholar]
- Dewey K. G., Peerson J. M., Brown K. H., Krebs N. F., Michaelsen K. F., Persson L. A., Salmenpera L., Whitehead R. G., Yeung D. L. Growth of breast-fed infants deviates from current reference data: a pooled analysis of US, Canadian, and European data sets. World Health Organization Working Group on Infant Growth. Pediatrics. 1995 Sep;96(3 Pt 1):495–503. [PubMed] [Google Scholar]
- Evans T. J., Davies D. P. Failure to thrive at the breast: an old problem revisited. Arch Dis Child. 1977 Dec;52(12):974–975. doi: 10.1136/adc.52.12.974. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harding D., Cairns P., Gupta S., Cowan F. Hypernatraemia: why bother weighing breast fed babies? Arch Dis Child Fetal Neonatal Ed. 2001 Sep;85(2):F145–F145. doi: 10.1136/fn.85.2.F145a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laing I. A., Wong C. M. Hypernatraemia in the first few days: is the incidence rising? Arch Dis Child Fetal Neonatal Ed. 2002 Nov;87(3):F158–F162. doi: 10.1136/fn.87.3.F158. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maisels M. J., Gifford K., Antle C. E., Leib G. R. Jaundice in the healthy newborn infant: a new approach to an old problem. Pediatrics. 1988 Apr;81(4):505–511. [PubMed] [Google Scholar]
- Maisels M. J., Gifford K. Breast-feeding, weight loss, and jaundice. J Pediatr. 1983 Jan;102(1):117–118. doi: 10.1016/s0022-3476(83)80305-9. [DOI] [PubMed] [Google Scholar]
- Marchini G., Fried G., Ostlund E., Hagenäs L. Plasma leptin in infants: relations to birth weight and weight loss. Pediatrics. 1998 Mar;101(3 Pt 1):429–432. doi: 10.1542/peds.101.3.429. [DOI] [PubMed] [Google Scholar]
- Marchini G., Stock S. Thirst and vasopressin secretion counteract dehydration in newborn infants. J Pediatr. 1997 May;130(5):736–739. doi: 10.1016/s0022-3476(97)80015-7. [DOI] [PubMed] [Google Scholar]
- Oddie S., Richmond S., Coulthard M. Hypernatraemic dehydration and breast feeding: a population study. Arch Dis Child. 2001 Oct;85(4):318–320. doi: 10.1136/adc.85.4.318. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams A. F. Weighing breast fed babies. Arch Dis Child Fetal Neonatal Ed. 2002 Jan;86(1):F69–F69. doi: 10.1136/fn.86.1.F69. [DOI] [PMC free article] [PubMed] [Google Scholar]