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Predisposing factors for excessive loss of weight in exclusively breastfed term and late preterm neonates - a case
Dhanya Jayaraj1, Suman Rao1, Bharathi Balachander1
1Department of Neonatology, St. John's Medical College Hospital, Bengaluru, India.
Insights
Excessive weight loss in exclusively breastfed newborns is linked to poor latch, high maternal postpartum depression scores, and lack of early skin-to-skin contact. These factors increase the risk for significant infant weight loss.
Area of Science:
- Neonatal care
- Lactation studies
- Maternal-infant health
Background:
- Exclusively breastfed neonates may experience excessive weight loss due to issues with milk production, intake, or transfer.
- Existing research on risk factors for infant weight loss is varied and inconsistent.
Purpose of the Study:
- To identify specific risk factors associated with over 10% weight loss in term and late preterm exclusively breastfed newborns.
Main Methods:
- A case-control study was conducted in a tertiary care hospital.
- Cases were exclusively breastfed neonates (≥34 weeks) with >10% weight loss within 14 days; controls were matched neonates without significant weight loss.
- Data collected included demographics, LATCH scores, maternal Edinburgh Postnatal Depression Scale (EPDS) scores, and neonatal morbidities.
Main Results:
- Gestational Diabetes Mellitus (GDM), Lower Segment Caesarean Section (LSCS), higher EPDS scores, low LATCH scores, and absence of immediate skin-to-skin contact were statistically significant risk factors for excessive weight loss.
- Infants in the excessive weight loss group had higher incidences of jaundice, hypernatremia, and longer hospital stays.
Conclusions:
- Lack of early skin-to-skin contact, elevated maternal EPDS scores, and low LATCH scores are key predisposing factors for excessive weight loss in exclusively breastfed infants.
Background:
Exclusively breastfed healthy neonates can lose weight excessively due to poor milk production, inadequate enteral intake or due to poor milk transfer. The studies assessing risk factors for infants to lose weight excessively are diverse and results are highly varied.
Objectives:
We aimed to determine the risk factors for weight loss of over 10% in term and late preterm newborns who were exclusively breastfed.
Methods:
This was a case-control study which was conducted in a tertiary care hospital. Exclusively breastfed neonates of ≥34 weeks having weight loss of >10% in the first 14 days of life comprised the study group with gestational age and weight-matched neonates without significant weight loss forming the control group. Demographic details, LATCH score, maternal EPDS (Edinburg postpartum depression score) and neonatal morbidities were assessed.
Results:
Of the 53 mother-infant dyad in each group, baseline characteristics were similar. Gestational Diabetes Mellitus (GDM), Lower segment Caesarean section (LSCS) delivery, higher EPDS score, low LATCH score, absence of immediate skin to skin contact were associated with excessive weight loss and was found to be significant statistically. Babies in the study group had higher incidence of jaundice and hypernatremia and had longer duration of stay in hospital.
Conclusion:
Lack of early skin to skin contact, higher EPDS scores and lower LATCH scores are predisposing factors for exclusively breastfed infants to lose weight excessively.
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