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Original Article

Does weight loss on day one of life predict subsequent weight loss due to poor breastfeeding technique during the immediate newborn period? A hospital-based study in a tertiary care hospital in Sri Lanka.

Authors:

M. N. Lucas ,

University of Colombo, LK
About M. N.
Department of Paediatrics

University Neonatal Unit, De Soysa Hospital for Women, Colombo
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M. Paranchothy,

University of Colombo, LK
About M.
Department of Paediatrics
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Ahamed F.A. Zulficar,

De Soysa Hospital for Women, Colombo, LK
About Ahamed F.A.
University Neonatal Unit
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S. C. Rupasinghe,

De Soysa Hospital for Women, Colombo, LK
About S. C.
University Neonatal Unit
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J. M. A. D. Jayasinghe

De Soysa Hospital for Women, Colombo, LK
About J. M. A. D.
University Neonatal Unit
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Abstract

Background: Weight measurement is used to assess breastfeeding adequacy. Initial weight loss within the first few days occurs due to the insensible water loss and loss of fluid by voiding during where oral intake of milk is still low. Excessive weight loss indicates insufficient milk transfer. Objective: To determine if weight loss ≥5% on day one predicted an eventual weight loss ≥10% and if weight loss of ≥5% was associated breastfeeding technique.


Methodology: A prospective longitudinal study was conducted at the University Unit, De Soysa Hospital for Women, Colombo, Sri Lanka on all live births more than 34weeks-gestation from 15/04/2014. Babies with congenital abnormalities and those that required admission to the neonatal unit were excluded. Weight was measured daily using the same scale (SECA 334) until discharge. All mothers were counselled and were provided hands on, one-to-one practical support regarding breastfeeding. All babies were reviewed within 2-3 days of discharge with clinic follow up until reaching birth weight. The weight nadir was taken as the lowest weight recorded before achieving the birth weight.


Results: We had a study population of 377 exclusively breastfed babies where 51% were boys. Mean gestational age was 38±2.2 weeks whereas mean birth weight was 2.91±0.45kg (1.380–4.965kg) where 16.7% were low birth weight (<2.5kg). Breastfeeding technique was satisfactory in 49% with poor attachment in 42%, poor positioning in 1% and both poor positioning and attachment in 8%. The mean weight loss on day one was 3.5±2.6% where most babies (79.4%) had a weight loss of less than 5%. The mean weight loss was 6.7±3.7% by day 2 of age. Babies who lost ≥5% of weight on day one were more likely to lose ≥5% of weight on day 2 (p<0.001) and have a weight nadir of ≥10% (p<0.001). Weight nadir occurred at an average age of 3.3 days. Babies with ≥5% weight loss were more likely to be preterm (p=0.004), be born via caesarean section (p-0.007), have a poor breastfeeding technique (p=0.003) and get readmitted for feeding support (p<0.001).


Conclusion: Weight loss ≥5% on day one predicts subsequent weight loss associated with poor breastfeeding technique.

How to Cite: Lucas MN, Paranchothy M, Zulficar AFA, Rupasinghe SC, Jayasinghe JMAD. Does weight loss on day one of life predict subsequent weight loss due to poor breastfeeding technique during the immediate newborn period? A hospital-based study in a tertiary care hospital in Sri Lanka.. Sri Lanka Journal of Perinatal Medicine. 2022;3(1):17–24. DOI: http://doi.org/10.4038/sljpm.v3i1.52
Published on 12 May 2022.
Peer Reviewed

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