For years, if not decades, we have simply told mothers of breastfed babies to expect their infants to lose about 10 percent of their weight during their first week of life as mom’s breast milk comes in. Yet how reliable and valid is that comment?Flaherman et al. (doi: 10.1542/peds.2014-1532) attempted to look at the question of what is normal and abnormal early weight loss by gathering weights over time for over 161,000 infants who were over 36 weeks gestational age and exclusively breastfed.
The authors discovered differential weight loss by mode of delivery (vaginal versus caesarean) within hours of delivery and created nomograms to show birthweight loss over time and percentiles for those curves so as to identify neonates falling off curves, showing greater weight loss, and in turn signaling perhaps other morbidities preventing the good beginning infants need to get out of the starting gate.
These nomograms, as contained in this article and further discussed in an interesting accompanying commentary by Drs. James Taylor and Elizabeth Simpson (doi: 10.1542/peds.2014-3354), should be posted in your local nursery and used frequently in determining just how much you and the mother of your newest patients need to worry or intervene to insure adequate breastfeeding and in turn weight gain occurs in the early days of a baby’s life.
Chart a course for this study and learn more about these new nomograms.
