Newborn Weight Change and Breastfeeding Practice During First Days of Life

Objective: Weight changes in the newborn during the initial days after delivery are scrutinized by the medical birthing facilities. Weight gain or more commonly weight losses, drive the need for supplementation of the breastfed newborn.  Having an initial weight loss of 7% or more during the first days of life is reason to give artificial milk to breastfed newborns. There is very limited literature that determines how a 7% weight loss was used as the guideline to supplement for weight loss. The purpose of this study was to determine a natural weight loss for breastfed, exclusive and non-exclusive, newborns that are not exposed to common medical interventions in a hospital setting.

Design: Retrospective

Setting: A freestanding, non-profit birth center in Northeastern Ohio.

Sample: Healthy, breastfeeding mothers who were 18 years and older with uncomplicated vaginal deliveries. Healthy, full term singleton infants with no apparent facial deformity/malformation identified medical problems, and a five minute APGARS > 7 were included.

Methods: Random charts were selected from 2009-2010. Variables of interest during first days post-delivery included elimination patterns (number of voids and number of stools), weight change (birth weight and a subsequent weight measurement within first days), and mothers documented number of BF episodes. Data regarding medication and intravenous fluids during labor were also collected.

Results: A total of 110 randomly selected charts were reviewed; 69 had a weight measurement within the first 24 hours and 36 were exclusively breastfed. During the first 24 hours, the mean percent of weight loss was 2.9% for exclusively breastfed infants and 2.5% for non-exclusively breastfed infants. Infant’s breastfed an average of eight times and provided supplemental feedings twice. At discharge (44 to 45.9 hours postbirth), the mean weight loss was 5.1% for exclusively breastfed infants and 4.9% for non- exclusively breastfed infants.

Conclusion/Implications for nursing practice: Breastfed newborns do lose weight in the first days of life when there are minimal medical interventions available in the birthing environment. This study is a first step in establishing a baseline for weight loss in exclusively breastfed newborns. More studies are needed to better understand the weight change patterns and breastfeeding practices in infants born in minimal medical interventions vs. non-minimal medical interventions environment within the first days post birth.

Keywords: Exclusively breastfeeding, minimal medical interventions, newborn weight