Excessive Weight Loss in Breastfed Infants During the Postpartum Hospitalization

Mulder PJ, Johnson TS, Baker LC.
J Obstet Gynecol Neonatal Nurs. 2010 Jan;39(1):15-26.


OBJECTIVE: To examine differences in breastfeeding frequency, voids, and stools in infants with weight losses < or > or =7% during the postpartum hospitalization.

DESIGN: Secondary analysis of data from a primary psychometric study examining the Mother Infant Breastfeeding Progress Tool (MIBPT). Setting: A midwestern community hospital in a multicultural racially diverse community.

PARTICIPANTS: Convenience sample of 53 breastfeeding women and infants hospitalized after birth.

METHODS: Data were collected during a chart review; infants were divided into < or > or =7% weight loss groups at 2 days postpartum, and breastfeeding frequency, voiding, and stooling were examined between groups and used to predict a > or =7% weight loss at 2 days postpartum.

RESULTS: Of the 53 infants, 20.8% lost > or =7% of their birth weight. Infants who lost > or =7% of their birth weight had significantly more total voids and a higher breastfeeding frequency on the day of birth than infants who lost <7% of their birth weight. A logistic regression analysis resulted in total voids being the only significant predictor of a > or =7% weight loss, with an odds ratio of 1.74 (95% CI=1.09, 2.75, p < .05).

Conclusion: In the absence of other indicators of ineffective breastfeeding, breastfeeding infants who lose > or =7% of their birth weight during the first 2 days postpartum might be experiencing a physiologic diuresis after birth, unrelated to their breastfeeding behaviors. More research is necessary to determine the cause of a > or =7% weight loss in newborns during the first 48 hours after birth.

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