The first few days of a newborn's life are a period of significant adaptation, marked by several physiological changes. One of the most noticeable of these changes is weight loss. Parents are often taught that it’s normal for babies to lose 7-10% of their body weight in the first few days after birth. Understanding the causes and implications of this weight loss is crucial for ensuring the well-being of the infant.
Normal Weight Loss in Newborns
Neonatal weight loss (NWL) in the first few days of life is a common phenomenon, in which infants lose weight after birth before starting to gain weight. Babies are born with some extra fluid, so it's normal for them to drop a few ounces when they lose that fluid in the first few days of life. A healthy newborn is expected to lose 7% to 10% of the birth weight, but should regain that weight within the first 2 weeks or so after birth. During their first month, most newborns gain weight at a rate of about 1 ounce (30 grams) per day and generally grow in height about 1 to 1½ inches (2.54 to 3.81 centimeters) during the first month. Many newborns go through a period of rapid growth when they are 7 to 10 days old and again at 3 and 6 weeks. The rate of NWL has been reported as 4% to 7%. A systematic review study reported that the mean rate of NWL was 3.79% to 8.6%.
Factors Influencing Newborn Weight Loss
Several factors can influence the extent of weight loss in newborns. These include:
- Feeding Method: Breastfed newborns should lose no more than 7 percent of birth weight in the first few days after birth before starting to gain weight again. The extent of weight loss, though variable from baby to baby, is in general greater in the breastfed babies as compared to those on formula. The mean WL in infants, who were exclusively breastfed (4.89 ± 2.86%) was higher than those fed with infant formula (2.78 ± 1.65%). Indicated that bottle fed babies initially lose less weight. Breastfeeding increases WL ≥ 5% and WL ≥ 7% by 7 and 3 times, respectively, and this variable was the strongest predictor of NWL.
- Mode of Delivery: Cesarean section was another factor associated with NWL. Researchers believe that feeding less than optimal levels after C-section may lead to greater levels of NWL. In fact, despite the promotion of “natural” CS and special training programs about breastfeeding, CS oppositely affects the initiation and duration of breastfeeding, especially after emergency cesarean section, and lower values of breastfeeding may be due to a lack of mother’s recovery after surgery.
- Infant Characteristics: In a study conducted by Jane (2010), female gender was one of the predictors of NWL in the first 24 hours after birth. In the present study, infants weighing more than 4000 grams lost more weight than others.
- Maternal Factors: Although no significant relationship was found between WL and parity in the present study, WL in infants of mothers, who had no experience of breast feeding was reported to be 5% to 7%.
Excessive Weight Loss: When to Worry
Losing weight by more than 5% to 7% is considered as a warning sign of excessive weight loss (EWL). International association of breastfeeding (10) and American academy of breastfeeding (11) recommend that if infants lose weight more than 7%, they should be examined and receive a medical intervention. Weight loss rate among infants with hypernatremia has been reported from 8% to 30%. Determining whether an exclusively breastfed newborn is losing excessive weight is important because higher weight loss almost always reflects suboptimal milk intake. It is also associated with increased risk of medical complications such as low blood sugar, jaundice, and dehydration, which can result in the need for medical interventions and future health and developmental problems.
Previously 7% weight loss was believed to be normal and safe for all newborns but if they lose this amount in the first 24 hours, this would be considered excessive weight loss that is greater than what is lost by 95% of all exclusively breastfed newborns. This may be a sign of insufficient breast milk supply and/or poor transfer of milk.
Read also: Normal Skin Fade Cream Analysis
The Newborn Weight Tool (NEWT)
Weight loss has typically been assessed using simple percentages, but now there is a much more precise and accurate way to track excessive weight loss in newborns and many hospitals, pediatricians, and lactation consultants are adopting this method for greater accuracy in making clinical recommendations. The Newborn Weight Tool, or NEWT, is an online tool, the first of its kind, to help pediatricians determine whether exclusively breastfed newborns have lost too much weight in the first days of life.
When you submit the data, the tool will plot the weight loss data on a graph. With this tool, excessive weight loss can be detected earlier. Supplementation with milk bank donor milk or formula would be strongly recommended at this time if the correction of the latch is unable to stabilize the weight loss. Earlier detection and supplementation can prevent complications that could require hospital interventions and longer hospital stays.
Potential Complications of Excessive Weight Loss
Hypernatremic dehydration is a potentially destructive condition, which occurs in infants, who lose weight excessively and can cause serious medical complications and even death. Studies shows that hypernatremia can occur by 5% weight loss, more typically at weight loss greater than 7% of birth weight. The data also shows that among healthy exclusively breastfed newborns, hypoglycemia and the complications it causes to the brain can occur at any weight loss percentage, because some infants are born with low caloric stores.
Monitoring and Intervention
Parents are taught that it’s normal for babies to lose 7-10% of their body weight in the first few days after birth, but is this true? Well, that depends. Any newborn with signs of persistent HUNGER (which we have summarized in this article) deserves a full assessment of these hunger cues, clinical signs of dehydration, jaundice, and hypoglycemia which may require blood work, particularly when the weight is above 5-7%.
If concerns about weight loss or an apparently unwell infant, interventions and support could be provided. Supplementation with milk bank donor milk or formula would be strongly recommended at this time if the correction of the latch is unable to stabilize the weight loss. Earlier detection and supplementation can prevent complications that could require hospital interventions and longer hospital stays.
Read also: Weight Loss Guide Andalusia, AL
Practical Tips for Parents
- Record Weights and Times: The first step is to record the weight in grams and time of the weighing each time it is done at your health facility, starting with the birth weight. Please note the weight time entered is in military time.
- Monitor Feeding: A breastfed baby may feed about 8 or more times in a 24-hour period; formula-fed babies usually eat less often, perhaps every 3 to 4 hours. A lactation (breastfeeding) counselor can make suggestions to increase comfort and improve technique, if a mom needs extra help.
- Observe Output: Expect about 6 wet diapers by 3 to 5 days of age for all babies. After that, babies should have at least 6 to 8 wet diapers a day.
- Trust Your Instincts: We encourage all mothers to listen to their instincts and raise concerns about their infants when they exhibit persistent signs of hunger despite frequent breastfeeding.
Read also: Beef jerky: A high-protein option for shedding pounds?