Physiologic weight loss in breast-fed newborn infants

Nurses working in newborn nurseries should be aware of the effects of the present system of providing nourishment for newborn infants. The current feeding practice is to begin artificially-fed infants on formula at 12 hours after birth while breast-fed infants are provided a solution of glucose water as needed until the mother begins lactation, usually three day after birth. Because there is a difference in the caloric value of these two preparations, a questions is raised as to whether there is a greater initial weight loss in breast-fed infants compared to artificially-fed infants during the first 72 hours of life. The intent of the present study was: 1) to determine the mean physiological weight loss in a group of breast-fed infants, 2) to compare the mean weight loss in a group of breast-fed infants with the mean weight loss in a similar group of artificially-fed infants, and 3) to establish whether the largest increment of weight decrease occurs during the first 12 to 24 hours of life. Surface area of the infants was used to determine if it was related to the amount of weight lost. A sample of 321 neonates born in a large suburban hospital was studied. Data were collected over a three month period and included the infant's birth weight and weights at 12, 24, 48, and 72 hours. Temperatures and length at birth were obtained from the infant's hospital record. Negative correlations between surface area and man per cent weight loss were obtained but were not significant. The mean weight loss of breast-fed infants was 4.25 per cent as compared to 3.02 per cent of newborns given formula. Girls from the breast-fed sample lost the greatest amount of weight during the 12 to 24 hour period but all infants lost approximately the same per cent of weight during the first 12 hours. Artificial-fed infants at 48 hours began to regain weight. Breast-fed infants continued to lose weight until 72 hours. The mean percentage weight loss of both groups of infants was below the 5 to 10 per cent range usually quoted by authors of medical texts. Replication of this study is recommended to determine the relationship between caloric content of feedings and initial weight loss in newborns.