Newborn Weight Loss During Birth Hospitalization and Breastfeeding Outcomes Through Age 1 Month

Abstract

Background:

Weight loss is universal for exclusively breastfed newborns in the first few days after birth. Many newborns exclusively breastfed during birth hospitalization receive formula in the first month after discharge and thus cease exclusive breastfeeding. However, the relationship between early weight loss and subsequent cessation of breastfeeding and exclusive breastfeeding is unknown.

Research aim:

This study aimed to determine the relationship between newborn weight loss and duration and exclusivity of breastfeeding among newborns breastfed exclusively during the birth hospitalization.

Methods:

Retrospective cohort study at Kaiser Permanente Northern California hospitals between 2009 and 2013. The main predictor variable was weight loss during birth hospitalization. The main outcomes were cessation of breastfeeding and cessation of exclusive breastfeeding in the first 25 days after discharge.

Results:

Among our sample, 83,344 were exclusively breastfed during birth hospitalization. At 25 days after discharge, 15.6%, 95% confidence interval (CI) [14.6%, 16.6%], of those delivered vaginally and 17.6%, 95% CI [14.5%, 20.6%], of those delivered by cesarean section were estimated to have completely ceased breastfeeding; 57.0%, 95% CI [55.5%, 58.4%], and 57.9%, 95% CI [53.6%, 61.8%], respectively, had ceased exclusive breastfeeding. Survival curves depicting rates of breastfeeding cessation through 1 month did not differ by degree of weight loss or by weight loss trajectory. However, curves depicting rates of exclusive breastfeeding demonstrated significantly more formula use among those with more weight loss at discharge.

Conclusion:

Among those exclusively breastfed during birth hospitalization, weight loss nomograms may help identify newborns at higher risk of cessation of exclusive breastfeeding. Lactation support targeted to those with exacerbated weight loss trajectories may improve duration of exclusive breastfeeding.

Keywords

breastfeeding breastfeeding duration breastfeeding support exclusive breastfeeding health services research lactation

Get full access to this article

View all access options for this article.

References

California Department of Public Health. (2013). California in-hospital breastfeeding. Retrieved from http://www.cdph.ca.gov/data/statistics/Documents/MO-MCAH-HospitalTotalsReport2012.pdf

Centers for Disease Control and Prevention. (2013a). Breastfeeding report card: United States/2013. Retrieved from http://www.cdc.gov/breastfeeding/pdf/2013BreastfeedingReportCard.pdf

Centers for Disease Control and Prevention. (2013b). Maternal, infant and child health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives

Centers for Disease Control and Prevention. (2016). Breastfeeding report card. Retrieved from https://www.cdc.gov/breastfeeding/data/reportcard.htm

DiGirolamo

A. M.

Grummer-Strawn

L. M.

Fein

S. B.

(2008). Effect of maternity-care practices on breastfeeding. Pediatrics, 122(Suppl. 2), S43–S49. doi:10.1542/peds.2008-1315e

Flaherman

V. J.

Schaefer

E. W.

Kuzniewicz

M. W.

S. X.

Walsh

E. M.

Paul

I. M.

(2015). Early weight loss nomograms for exclusively breastfed newborns. Pediatrics, 135(1), e16–e23. doi:10.1542/peds.2014-1532

Holmes

A. V.

Auinger

Howard

C. R.

(2011). Combination feeding of breast milk and formula: Evidence for shorter breast-feeding duration from the National Health and Nutrition Examination Survey. Journal of Pediatrics, 159(2), 186–191. doi:10.1016/j.jpeds.2011.02.006

Macdonald

P. D.

Ross

S. R.

Grant

Young

(2003). Neonatal weight loss in breast and formula fed infants. Archives of Disease in Childhood Fetal and Neonatal Edition, 88(6), F472–F476.

Noel-Weiss

Woodend

A. K.

Peterson

W. E.

Gibb

Groll

D. L.

(2011). An observational study of associations among maternal fluids during parturition, neonatal output, and breastfed newborn weight loss. International Breastfeeding Journal, 6, 9. doi:10.1186/1746-4358-6-9

10.

Petrova

Hegyi

Mehta

(2007). Maternal race/ethnicity and one-month exclusive breastfeeding in association with the in-hospital feeding modality. Breastfeeding Medicine, 2(2), 92–98. doi:10.1089/bfm.2006.0030

11.

Sun

(1996). A non-parametric test for interval-censored failure time data with application to AIDS studies. Statistics in Medicine, 15(13), 1387–1395.

12.

Turnbull

B. W.

(1976). The empirical distribution function with arbitrarily grouped, censored and truncated data. Journal of the Royal Statistical Society. Series B (Methodological), 38(3), 290–295.

13.

U.S. Department of Health and Human Services. (2011). The surgeon general’s call to action to support breastfeeding. Washington, DC: Government Printing Office.

14.

van Dommelen

van Wouwe

J. P.

Breuning-Boers

J. M.

van Buuren

Verkerk

P. H

. (2007). Reference chart for relative weight change to detect hypernatraemic dehydration. Archives of Disease in Childhood, 92(6), 490–494. doi:10.1136/adc.2006.104331

15.

World Health Organization. (2011). Nutrition: Exclusive breastfeeding. Retrieved from http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/