Factors Associated With Newborn In-Hospital Weight Loss: Comparisons by Feeding Method,Demographics,and Birthing Procedures

Abstract

Full-term newborn normative weight loss and factors influencing this were determined through chart audits (n = 812) at 6 hospitals in Manitoba, Canada. The effects of parity, gestational age, birth weight, sex, length of stay, type of delivery (cesarean vs vaginal), epidural use, and type of infant feeding (exclusively breastfed, partially breastfed, exclusively formula-fed) on percentage weight loss in hospital were analyzed using multiple regression analysis. In-hospital weight loss was 5.09% ± 2.89% (95% CI, 4.89-5.29), varying by feeding category: exclusively breastfed 5.49% ± 2.60% (95% CI, 5.23-5.74), partially breastfed 5.52% ± 3.02% (95% CI, 5.16-5.88), and formula-fed 2.43% ± 2.12% (95% CI, 2.02-2.85). Factors significantly increasing the percentage weight loss included higher birth weight, female sex, epidural use, and longer hospital stay. Lower percentage weight loss was associated with greater gestational age and exclusive formula feeding. Parity and type of delivery were not significant. Controlling for demographic and delivery-related variables, exclusive formula feeding had the largest impact, with 3.1% less weight loss than exclusive breastfeeding. J Hum Lact. 23(3):233-241.

Keywords

breastfeeding weight gain weight loss obesity overweight infant feeding

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References

World Health Organization. Protecting, Promoting and Supporting Breast-Feeding—The Special Role of Maternity Services. A Joint WHO/UNICEF Statement. Geneva , Switzerland: World Health Organization; 1989.

Lawrence RA , Lawrence RM Breastfeeding: A Guide for the Medical Profession. 6th ed. St Louis, Mo: Elsevier Mosby; 2005.

Riordan J. Breastfeeding and Human Lactation. 3rd ed. Sudbury, Mass: Jones & Bartlett ; 2005.

Taeusch HW , Ballard RA , Gleason CA Avery's Diseases of the Newborn. 7th ed. Philadelphia, Pa: Saunders; 2005 .

Dewey KG , Nommsen-Rivers LA , Heinig MJ , et al. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics . 2003;112:607-619.

Rodriguez G. , Ventura P. , Samper MP , et al. Changes in body composition during the initial hours of life in breast-fed healthy term newborns. Biol Neonate. 2000;77:12-16.

Macdonald PD , Ross SR , Grant L. , et al. Neonatal weight loss in breast and formula fed infants. Arch Dis Child Fetal Neonatal Ed. 2003; 88:F472-F476.

Manganaro R. , Mami C. , Marrone T. , et al. Incidence of dehydration and hypernatremia in exclusively breast-fed infants. J Pediatr. 2001;139: 673-675.

Marchini G. , Stock S. Thirst and vasopressin secretion counteract dehydration in newborn infants . J Pediatr. 1997;130:736-739.

10.

Marchini G. , Fried G. , Ostlund E. , et al. Plasma leptin in infants: relations to birth weight and weight loss. Pediatrics. 1998;101:429-432.

11.

Wright CM , Parkinson KN

Postnatal weight loss in term infants: what is normal and do growth charts allow for it?

Arch Dis Child Fetal Neonatal Ed. 2004;89:F254-F257.

12.

Dollberg S. , Lahav S. , Mimouni FB A comparison of intakes of breastfed and bottle-fed infants during the first two days of life. J Am Coll Nutr . 2001;20:209-211.

13.

Casiday RE , Wright CM , Panter-Brick C. , et al. Do early infant feeding patterns relate to breast-feeding continuation and weight gain? Data from a longitudinal cohort study. Eur J Clin Nutr. 2004;58:1290-1296.

14.

Crowell MK , Hill PD , Humenick SS Relationship between obstetric analgesia and time of effective breastfeeding . J Nurse Midwifery. 1999; 39:150-156.

15.

Riordan J. , Gross A. , Angeron J. , et al. The effect of labor pain relief medication on neonatal suckling and breastfeeding duration. J Hum Lact. 2000 ;16:7-12.

16.

Ransjo-Arvidson AB , Matthiesen AS , Lilja G. , et al. Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying. Birth. 2001;28:5-12.

17.

Sepkoski CM , Lester BM , Ostheimer GW , et al. The effects of maternal epidural anesthesia on neonatal behavior during the first month. Dev Med Child Neurol. 1992;34:1072-1080.

18.

Henderson JJ , Dickinson JE , Evans SF , et al. Impact of intrapartum epidural analgesia on breast-feeding duration . Aust N Z J Obstet Gynaecol. 2003;43:372-377.

19.

Cotton DB , Gonik B. , Spillman T. , Dorman KF Intrapartum to postpartum changes in colloid osmotic pressure. Am J Obstet Gynecol. 1984;149:174-177.

20.

Gonik B. , Cotton DB Peripartum colloid osmotic pressure changes: influence of intravenous hydration . Am J Obstet Gynecol. 1984;150:99-100.

21.

Miller V. , Riordan J. Treating postpartum breast edema with areolar compression. J Hum Lact. 2004;20:223-226.

22.

Hirose M. , Hosokawa T. , Tanaka Y. Extradural buprenorphine suppresses breast feeding after caesarean section . Br J Anaesth. 1997; 79:120-121.

23.

Dahlenburg GW , Burnell RH , Braybrook R. The relationship between cord serum sodium levels in newborn infants and maternal intravenous therapy during labor. Br J Obstet Gynaecol. 1980;87:519-522.

24.

Daly SE , Owens RA , Hartmann PE The short-term synthesis and infant-regulated removal of milk in lactating women. Exp Physiol. 1993;78:209-220.

25.

Dewey K. , Lonnerdal B. Infant self-regulation of breast milk intake. Acta Paediatr Scand. 1986;75:893-898.

26.

Dewey KG , Heinig MJ , Nommsen LA , et al. Maternal versus infant factors related to breast milk intake and residual milk volume: the DARLING study. Pediatrics. 1991;87:829-837.

27.

Dewey KG , Heinig MJ , Nommsen LA , et al. Growth of breast-fed and formula-fed infants from 0 to 18 months: the DARLING Study. Pediatrics. 1992;89:1035-1041.

28.

Kent JC , Mitoulas L. , Cox DB , et al. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999;84:435-447.

29.

Matheny RJ , Birch LL , Picciano MF Control of intake by human-milk-fed infants: relationship between feeding size and interval. Dev Psychobiol. 1990;23:511-518.

30.

Neville MC , Keller R. , Seacat J. , et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lacation. Am J Clin Nutr. 1988;54:81-92.

31.

Stuart-Macadam P. , Dettwyler K. Breastfeeding : Biocultural Perspectives. Hawthorne, NY: Aldine de Gruyter ; 1995.

32.

Woolridge M. Returning control of feeding to the infant. Paper presented at: the LLL of Texas Area Conference; July 24-26, 1992; Houston, Tex.

33.

Mannel R , Martens PJ , Walker M , eds. Core Curriculum for Lactation Consultant Practice (International Lactation Consultants' Association). 2nd ed. Sudbury, Mass: Jones & Bartlett ; 2008.

34.

Biancuzzo M. Breastfeeding the Newborn: Clinical Strategies for Nurses. St Louis, Mo: Mosby; 1999.

35.

Houston MJ , Howie PW , McNeilly AS Factors affecting the duration of breast feeding: 1. Measurement of breast milk intake in the first week of life. Early Hum Dev. 1983;8:49-54.

36.

Casey CE , Neifert MR , Seacat JM , et al. Nutrient intake by breast-fed infants during the first five days after birth. Am J Dis Child. 1986; 140:933-936.

37.

Hartmann PE Lactation and reproduction in Western Australian women. J Reprod Med. 1987;32:543-547.

38.

Hartmann PE , Prosser CG Physiological basis of longitudinal changes in human milk yield and composition. Fed Proc. 1984;43:2448-2453.

39.

Levin BE Metabolic imprinting on genetically predisposed neural circuits perpetuates obesity. Nutrition. 2000;16:909-915.

40.

Birch LL , Fisher JO Development of eating behaviors among children and adolescents. Pediatrics. 1998;101:539-549.

41.

Osborn LM , DeWitt TG , Lewis R. , et al. Pediatrics. St Louis, Mo: Elsevier Mosby; 2005.

42.

Behrman RE , Kliegman R. , Jenson HB Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: Saunders; 2005 .

43.

Lucas A. Programming by early nutrition: An experimental approach. J Nutr. 1998;128(2 suppl):401S-406S.

44.

Plagemann A. , Rake A. , Harder T. , et al. Reduction of cholecystokinin-8S-neurons in the paraventricular hypothalamic nucleus of neonatally overfed weanling rats. Neurosci Lett. 1998;258:13-16.

45.

Plagemann A. , Harder T. , Rake A. , et al. Obervations on the orexigenic hypothalamic neuropeptide Y-system in neonatally overfed weanling rats. J Neuroendocrinol. 1999;11:541-546.

46.

Voits M. , Forster S. , Rodel S. , et al. Obesity induced by unspecific early postnatal overfeeding in male and female rats: hypophagic effect of CCK-8S. Naunyn Schmiedebergs Arch Pharmacol. 1996;354:374-378.

47.

Waterland RA , Garza C. Early postnatal nutrition determines adult pancreatic glucose-responsive insulin secretion and islet gene expression in rats. J Nutr. 2002;132:357-364.

48.

Plagemann A. , Harder T. , Rake A. , et al. Perinatal elevation of hypothalamic insulin, acquired malformation of hypothalamic galaninergic neurons, and syndrome x-like alterations in adulthood of neonatally overfed rats. Brain Res. 1999;836:146-155.

49.

Balonan LC , Sheng H-P. Perinatal feedings adversely affect lipogenic activities but not glucose handling in adult rats. Pediatr Res. 2000;48:668-673.

50.

Stettler N. , Stallings VA , Troxel AB , et al. Weight gain in the first week of life and overweight in adulthood: a cohort study of European American subjects fed infant formula. Circulation. 2005;111:1897-1903.

51.

Owen CG , Martin RM , Whincup PH , et al. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics . 2005;115:1367-1377.

52.

Balaban G. , Silva GA Protective effect of breastfeeding against childhood obesity. J Pediatr (Rio J). 2004;80:7-16.

53.

Harder T. , Bergmann R. , Kallischnigg G. , Plagemann A. Duration of breastfeeding and risk of overweight: A meta-analysis. Am J Epidemiol. 2005;162:397-403.

54.

Arenz S. , Buckerl R. , Koletzko B. , von Kries R. Breast-feeding and childhood obesity—a systematic review . Int J Obes Relat Metab Disord. 2004;28:1247-1256.

55.

Gillman MW , Rifas-Shiman SL , Berkey CS , et al. Breastfeeding and overweight in adolescence. Epidemiology. 2006;17:112-114.

56.

Martens PJ , Fransoo R. , The Need To Know Team , et al. The Manitoba RHA Indicators Atlas: Population-Based Comparisons of Health and Health Care Use. Winnipeg, MB: Manitoba Centre for Health Policy; June 2003.

57.

Hintze JL NCSS 97 Statistical System for Windows. Kaysville, Utah : Number Cruncher Statistical Systems; 1997.

58.

Martens PJ , Phillips SJ , Cheang MS The Breastfeeding Promotion Steering Committee of Manitoba, Rosolowich V. How baby-friendly are Manitoba hospitals? The Provincial Infant Feeding Study . Can J Public Health. 2000;91:1-7.

59.

Provincial Coordinating Committee for the Implementation of Baby Friendly in Manitoba. Manitoba Breastfeeding Hospital Policy Template, 2001. Available at: http://www.gov.mb.ca/health/nutrition/pubs/hospitalpolicyyemplate.pdf. Accessed June 5, 2007.

60.

World Health Organization. Evidence for the Ten Steps to Successful Breastfeeding. Geneva, Switzerland: World Health Organization; 1998.

61.

Academy of Breastfeeding Medicine. ABM Protocol 3: Hospital guidelines for the use of supplementary feedings in the healthy term breastfed neonate. Available at: http://www.bfmed.org/ace-files/protocol/supplementation.pdf. Accessed June 5, 2007.