To determine a natural weight loss for breastfed, exclusive, and nonexclusive newborns that are not exposed to common medical interventions in a hospital setting.
A freestanding, nonprofit birth center in Northeastern Ohio.
Healthy, breastfeeding (BF) mothers who were 18 years and older with uncomplicated vaginal deliveries. Healthy, full-term singleton infants with no apparent facial deformity/malformations and 5-minute APGARS > 7 were included.
Random charts were selected from 2009 to 2010. Variables of interest during first days postdelivery 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.
A total of 110 randomly selected charts were reviewed, 69 infants 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 nonexclusively breastfed infants. Infants breastfed an average of eight times and were provided supplemental feedings twice. At discharge (44-45.9 hours post birth), the mean weight loss was 5.1% for exclusively breastfed infants and 4.9% for nonexclusively breastfed infants.
Conclusion/Implications for Nursing Practice
Weight changes in the newborn during the initial days after delivery are scrutinized by the medical birthing facilities. Weight gain or more commonly weight loss 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. 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 BF practices in infants born in environments with minimal medical interventions versus nonminimal medical interventions t within the first days post birth.