Challenging Expected Patterns of Weight Loss in Full-Term Breastfeeding Neonates Born by Cesarean

Diane Thulier
Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN 2017, 46 (1): 18-28

OBJECTIVE: To determine the mean weight loss (MWL) of newborns and to examine the effect of weight loss > 7% on exclusive breastfeeding rates.

DESIGN: A secondary analysis from a retrospective case-control study of maternal hydration and neonatal weight.

SETTING: A Level III maternity hospital in the Northeast region of the United States.

PARTICIPANTS: A total of 286 women and their term breastfeeding newborns born by cesarean.

METHODS: Data were collected by chart review from birth through Days 3 or 4. Newborns who lost more than 7% of birth weight by Day 3 were included in the case group, and newborns who lost 7% or less by Day 3 were included in the control group. A significance level of .05 was used for all statistical analysis.

RESULTS: Day 3 MWL for all newborns was 8% (n = 286, 7.9% ± 2.2%). MWL for the control group (n = 121) was 6% (5.93% ± 1.31%), and MWL for the case group (n = 165) was over 9% (9.35% ± 1.38%). Predominately breastfed newborns were still losing weight on Day 4 (MWL = 7.58%). Newborns who lost 7% or less had little change in exclusive breastfeeding, from 87% to 80% by Day 4. In contrast, exclusive breastfeeding in newborns who lost more than 7% dropped markedly, from 90% to 53% (p < .001).

CONCLUSION: Weight loss of more than 7% appears to be a normal phenomenon among full-term newborns. When weight loss reached 7%, formula supplementation increased markedly. Predominately breastfed newborns are most at risk for continued weight loss after hospital discharge.

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