Early weight loss nomograms for formula fed newborns

Area of Science:

• Neonatal Health
• Pediatric Nutrition
• Clinical Pediatrics

Background:

• Establishing normative data for infant weight loss is crucial for identifying potential feeding difficulties or morbidities.
• Existing data on newborn weight loss often does not differentiate by feeding type or delivery mode.
• Formula feeding is a common alternative or supplement to breastfeeding, necessitating specific reference standards.

Purpose of the Study:

• To develop percentile-based nomograms for early infant weight loss in exclusively formula-fed newborns.
• To stratify these nomograms by delivery mode (vaginal vs. cesarean).
• To provide a clinical tool for assessing normal weight loss patterns in neonates.

Main Methods:

• Utilized electronic medical records from 14 Kaiser Permanente Northern California hospitals (2009-2013).
• Included 161,471 healthy, term, singleton neonates born at ≥36 weeks' gestation.
• Applied quantile regression to create nomograms of weight loss percentiles as a function of age, stratified by delivery mode, excluding infants with any breast milk feeding.

Main Results:

• Analyzed data from 7,075 exclusively formula-fed newborns (4,525 vaginal, 2,550 cesarean).
• Median weight loss was 2.9% at 48 hours post-vaginal delivery; >7% weight loss was rare.
• Median weight loss for cesarean-delivered neonates was 3.7% at 48 hours and 3.5% at 72 hours; >8% weight loss was rare.

Conclusions:

• Developed nomograms for tracking weight loss in formula-fed newborns, differentiated by delivery mode.
• These nomograms can aid in classifying early infant weight loss.
• Facilitates early identification of feeding challenges or other neonatal health issues.