Excess weight loss in first-born breastfed newborns relates to maternal intrapartum fluid balance

The objectives were to describe weight loss in a multiethnic population of first-born, predominantly breastfed, term infants and to identify potentially modifiable risk factors for excess weight loss (EWL). Data on prenatal breastfeeding intentions, demographic characteristics, labor and delivery in...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2011-01, Vol.127 (1), p.e171-e179
Main Authors: Chantry, Caroline J, Nommsen-Rivers, Laurie A, Peerson, Janet M, Cohen, Roberta J, Dewey, Kathryn G
Format: Article
Language:English
Subjects:
Adult
Body fluids
Breast feeding
Breast Feeding - statistics & numerical data
Breastfeeding & lactation
Demographic aspects
Female
Fluid-electrolyte balance
Humans
Infant Formula
Infant, Newborn
Infants (Newborn)
Influence
Labor, Obstetric - metabolism
Male
Maternal & child health
Newborn babies
Newborn infants
Osmoregulation
Pediatrics
Physiological aspects
Pregnancy
Prospective Studies
Regression analysis
Risk Factors
Thinness - epidemiology
Water-Electrolyte Balance
Water-electrolyte balance (Physiology)
Weight
Weight Loss
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Summary:The objectives were to describe weight loss in a multiethnic population of first-born, predominantly breastfed, term infants and to identify potentially modifiable risk factors for excess weight loss (EWL). Data on prenatal breastfeeding intentions, demographic characteristics, labor and delivery interventions and outcomes, breastfeeding behaviors, formula and pacifier use, onset of lactogenesis, and nipple type and pain were collected prospectively. Logistic regression analyses identified independent predictors of EWL (≥10% of birth weight) by using a preplanned theoretical model. EWL occurred for 18% of infants who received no or minimal (≤60 mL total since birth) formula (n = 229), including 19% of exclusively breastfed infants (n = 134) and 16% of infants who received minimal formula (n = 95). In bivariate analyses, EWL was associated (P < .05) with higher maternal age, education, and income levels, hourly intrapartum fluid balance, postpartum edema, delayed lactogenesis (>72 hours), fewer infant stools, and infant birth weight. In multivariate logistic regression analysis, only 2 variables predicted EWL significantly, namely, intrapartum fluid balance (adjusted relative risk for EWL of 3.18 [95% confidence interval [CI]: 1.35-13.29] and 2.80 [95% CI: 1.17-11.68] with net intrapartum fluid balance of >200 and 100-200 mL/hour, respectively, compared with
ISSN:0031-4005
1098-4275
1098-4275
DOI:10.1542/peds.2009-2663