Risk Factors for Early Weight Loss in Breastfed and Term Newborns

Yıl 2021, , 247 - 253, 14.01.2022

Tijen Eren Bahar Kural , Gülbin Gökçay

https://doi.org/10.26650/jchild.2021.996186

Öz

Objective: Newborns lose some of their birth weight before hospital discharge. This loss is accepted as “physiological” up to 5-7%. Infants with weight loss over this range may receive undue formula supplementation. Formula supplementation disrupts exclusive breastfeeding, does not have the benefits of mother’s milk, and may cause low breastfeeding success in the long run. Identification of the risk factors affecting infant weight loss percentage in the few days following the birth will increase exclusive breastfeeding success. The aim of this study is to identify the risk factors that cause early weight loss in newborns before hospital discharge. Material and Methods: Weight loss in infants born between January 1, 2011, and December 31, 2014, at Vehbi Koç Foundation American Hospital was evaluated retrospectively. The hospital records of 3812 babies who completed the inclusion criteria were included in the study. The variables yielding significant results in binary tables were further evaluated by “Multivariate Logistic Regression”. Results: Delivering via caesarean section, primiparity, early term gestational week, older maternal age and female gender of the infant were statistically significant risk factors for early weight loss in newborns. Conclusion: To increase the success of breastfeeding in babies who are exclusively breastfed, the mother-infant pair identified with risk factors that contribute to infant weight loss must be closely monitored. Breastfeeding counselling should be repeated, and breastfeeding should be supported. Suggested intervention list is created aligned with the findings to assist mothers in risk management.

Anahtar Kelimeler

Early weight loss, new-born, risk factors

Destekleyen Kurum

Yok

Proje Numarası

--

Teşekkür

--

Anne Sütü ile Beslenen ve Term Yenidoğanlarda Erken Kilo Kaybı için Risk Faktörleri

Öz

Amaç: Yenidoğan bebekler hastane taburculuğu öncesi doğum kilolarının bir kısmını kaybetmektedirler. Belli bir orana kadar bu kayıp (%5-7) ‘fizyolojik’ olarak kabul edilmektedir. Kilo kaybı bu oranı geçen bebeklerde erken dönemde yersiz takviye başlanabilmektedir. Erken dönemde mama ile takviye sadece anne sütü ile beslenmeyi kesintiye uğratmakta, anne sütünün faydalarına sahip olmadığı gibi ve uzun vadede anne sütü ile beslenme başarısında düşüklüğe sebep olabilmektedir. Yenidoğan bebeklerde doğumu takip eden birkaç günde kilo kaybına etki eden risk faktörlerinin tespiti sadece anne sütü ile beslenme başarısını arttıracaktır. Çalışmanın amacı taburculuk öncesi yenidoğan bebeklerdeki kilo kaybına sebep olan risk faktörlerinin değerlendirilmesidir. Gereç ve Yöntemler: Vehbi Koç Vakfı Amerikan Hastanesi’nde 1 Ocak 2011- 31 Aralık 2014 arasında doğan bebeklerdeki kilo kaybı retrospektif dosya taraması olarak değerlendirilmiştir. Çalışmaya dahil edilme kriterlerini dolduran 3812 bebek çalışmaya alınmıştır. İkili tablolarda anlamlı sonuç veren değişkenler ‘Multivariate Lojistik Regresyon’ ile değerlendirilmişlerdir. Bulgular: Sezaryen doğum, parite, gestasyon haftasına göre erken term olma, ileri anne yaşı ve kız bebek cinsiyeti yenidoğanda erken kilo kaybı için istatiksel olarak anlamlı risk faktörleri olarak tespit edilmiştir. Sonuç: Sadece anne sütü alan bebeklerde emzirme başarısının artması için, kilo kaybında artışa sebep olan risk faktörlerine sahip olan gruplarda anne- bebek ikilisi yakın takip edilmelidir. Gerekirse emzirme danışmanlığı tekrarlanmalı ve anne sütü ile beslenme desteklenmelidir. Annelere risk yönetiminde yardımcı olmak için bulgulara uyumlu olarak önerilen müdahale listesi oluşturulmuştur.

Anahtar Kelimeler

Erken kilo kaybı, yenidoğan, risk faktörleri

Proje Numarası

--

Kaynakça

• 1. UNICEF/WHO. Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, Section 1, Background and Implementation, Preliminary version, 2009. https://apps.who.int/ iris/bitstream/handle/10665/43593/9789241594967_eng.pdf;js essionid=62D44EC8221A7324A9488561160A2B17?sequence=1 (Last Accessed date:10.09.2021). google scholar
• 2. Dewey KG, Nommsen-Rivers LA, Heinig MJ, Cohen RJ. Risk Factors for suboptimal infant breastfeeding behaviour, delayed onset of lactation and excess neonatal weight loss. Paediatrics 2003;112(3):607-19. DOI: 10.1542/peds.112.3.607 google scholar
• 3. Johnston M, Landers S, Noble L, Szucs K, Viehmann L; Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129(3):e827-e841. google scholar
• 4. Lewallen LP, Dick MJ, Flowers J, Powell W, Zickefoose KT, Wall YG. et al. Breastfeeding support and early cessation. J Obstet Gynecol Neonatal Nurs 2006;35(2):166-72. DOI: 10.1111/j.1552-6909.2006.00031.x google scholar
• 5. Chen YJ, Chen WC, Chen CM.Risk factors for hyperbilirubinemia in breastfed term neonates. Eur J Pediatr 2012;171(1):167-71. DOI: 10.1007/s00431-011-1512-8. google scholar
• 6. Livingstone VH, Willis CE, Abdel-Wareth LO, Thiessen P, Lockitch G. Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey. CMAJ 2000;162:647-52. PMID: 10738450; PMCID: PMC1231219. google scholar
• 7. Holmes AV, Auinger P, Howard CR. Combination feeding of breast milk and formula: Evidence for shorter breast-feeding duration from the National Health and Nutrition Examination Survey. J Pediatr 2011;159(2):186-91. DOI: 10.1016/j.jpeds.2011.02.006. google scholar
• 8. Thulier D. Challenging Expected Patterns of Weight Loss in Full-Term Breastfeeding Neonates Born by Cesarean. J Obstet Gynecol NeonatalNurs2017;46(1):18- 28.DOI:10.1016/j.jogn.2016.11.006. google scholar
• 9. Michel MP, Gremmo-Feger G, Oger E, Sizun J. Pilot study of early breastfeeding difficulties of term newborns:incidence and risk factors. Arch Pediatr 2007;14(5):454-60. DOI: 10.1016/j.arcped.2007.01.005 google scholar
• 10. Boies E, Vaucher YE and the Academy of Breastfeeding Medicine. ABM Clinical Protocol #10: Breastfeeding the late preterm (34-36 6/7 weeks of gestation) and early term infants (37-38 6/7 weeks of gestation) Second Revision 2016. Breastfeed Med 2016;11(10): 494-500. DOI: 10.1089/bfm.2016.29031.egb google scholar
• 11. Hamilcikan Ş, Gok V,Bent S, Can E. Early Weight Loss in Exclusively Breastfed Term Neonates. Iran J Pediatr 2017;27(2):e9497. DOI: 10.5812/ijp.9497 google scholar
• 12. Çaglar MK, Özer I, Altugan FS. Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Brazilian Journal of Medical and Biological Research 2006;39(4):539-44. DOI: 10.1590/s0100-879x2006000400015 google scholar
• 13. The American College of Obstetricians and Gynecologists Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 180: Gestational Diabetes Mellitus. Obstet Gynecol 2017;130(1):e17-e37.DOI:10.1097/AOG.0000000000002159. google scholar
• 14. Idris I, Srinivasan R, Simm A, Page RC. Maternal hypothyroidism in early and late gestation: effects on neonatal and obstetric outcome. Clin Endocrinol (Oxf) 2005;63(5):560-5. DOI: 10.1111/j.1365-2265.2005.02382.x google scholar
• 15. Vogel JP, Betran AP, Vindevoghel N, Souza JP, Torloni MR, Zhang J, et al. Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Glob Health 2015;3(5):e260-70. DOI: 10.1016/S2214-109X(15)70094-X google scholar
• 16. Kural B, Eren T, Gökçay G. Early Weight Loss Percentile Charts in Exclusively Breastfed Infants According to Mode of Delivery. Med J Bakirkoy 2020;16(2):182-9 doi: 10.5222/BMJ.2020.94830 google scholar
• 17. Santas G, Santas F. Trends of caesarean section rates in Turkey. J Obstet Gynaecol 2018;38(5):658-62. google scholar
• 18. Hacettepe University Institute of Population Studies (2019), “2018 Turkey Demographic and Health Survey”. Hacettepe University Institute of Population Studies, T.R. Ministry of Development and TÜBİTAK, Ankara, Turkey. google scholar
• 19. Fisher J, Hammarberg K, Wynter K, McBain J, Gibson F, Boivin J. et. al. Assisted conception, maternal age and breastfeeding: an Australian cohort study. Acta Paediatr 2013;102(10):970-6. DOI: 10.1111/apa.12336 google scholar
• 20. Mezzacappa MA, Ferreira BG. Excessive weight loss in exclusively breasted full-term newborns in a baby-friendly hospital. Rev Paul Pediatr 2016;34:281-6. DOI: 10.1016/j.rpped.2015.10.007. google scholar
• 21. Flaherman VJ, Aby J, Burgos AE, Lee KA, Cabana MD, Newman TB. Effect of early limited formula on duration and exclusivity of breastfeeding in at-risk infants: an RCT. Pediatrics 2013;131(6):1059-65. DOI: 10.1542/peds.2012-2809 google scholar
• 22. Flaherman VJ, Kuzniewicz M, Li S, Walsh E, McCulloch CE, Newman TB. First-day weight loss predicts eventual weight nadir for breastfeeding newborns. Arch Dis Child Fetal Neonatal Ed 2013;98:F488-F492. DOI: 10.1136/archdischild-2012-303076 google scholar
• 23. Kitano N, Nomura K, Kido M, Murakami K, Ohkubo T, Ueno M.et al. Combined effects of maternal age and parity on successful initiation of exclusive breastfeeding. Preventive Medicine Reports 2016;3:121-6. DOI: 10.1016/j.pmedr.2015.12.010 google scholar
• 24. Dennis CL, Coghlan M, Vigod S. Can we identify mothers at-risk for postpartum anxiety in the immediate postpartum period using the State-Trait Anxiety Inventory? Journal of Affective Disorders 2013;150:1217-20. DOI: 10.1016/j.jad.2013.05.049 google scholar
• 25. Kronborg H, Harder I, Hall EO. First time mothers’ experiences of breastfeeding their newborn. Sexual and Reproductive Healthcare 2015;6:82-7. DOI: 10.1016/j.srhc.2014.08.004 google scholar
• 26. Ekström A, Widström AM, Nissen E. Duration of breastfeeding in Swedish primiparous and multiparous women. J Hum Lact 2003; 19:172-8. DOI: 10.1177/0890334403252537 google scholar
• 27. Huang K, Yan S, Wu X, Zhu P, Tao F. Elective caesarean section on maternal request prior to 39 gestational weeks and childhood psychopathology: a birth cohort study in China. BMC Psychiatry 2019;19(1):22. DOI: 10.1186/s12888-019-2012-z. google scholar
• 28. Adamkin DH and Committee on Fetus and Newborn. Clinical Report- Postnatal Glucose Homeostasis in Late-Preterm and Term Infants. Pediatrics 2011;217(3):575-9. DOI: 10.1542/peds.2010-3851 google scholar
• 29. Fonseca MJ, Severo M, Barros H, Santos A. Determinants of weight changes during the first 96 hours of life in full-term newborns. Birth 2014;41(2):160-8. DOI: 10.1111/birt.12087 google scholar
• 30. Matias SL, Nommsen-Rivers LA, Creed-Kanashiro H, Dewey KG. Risk factors for early lactation problems among Peruvian primiparous mothers. Matern Child Nutr 2010;6(2):120-33. DOI: 10.1111/j.1740-8709.2009.00195.x google scholar
• 31. Bazzano AN, Cenac L, Brandt AJ, Barnett J, Thibeau S, Theall KP. Maternal experiences with and sources of information on galactagogues to support lactation: a cross- sectional study. Int J Womens Health 2017;9:105-13. DOI: 10.2147/IJWH.S128517 google scholar
• 32. World Health Organization. WHO child growth standards : growth velocity based on weight, length and head circumference : methods and development. 2009, World Health Organization. https://apps. who.int/iris/handle/10665/44026 (Last Accessed date:10.09.2021). google scholar
• 33. Holmes AV.Establishing successful breastfeeding in the newborn period. Pediatr Clin North Am 2013;60:147-68. DOI: 10.1016/j. pcl.2012.09.013 google scholar
• 34. Phillips R. The sacred hour: Uninterrupted skin-to-skin contact immediately after birth. Newborn & Infant Nursing Reviews 2013;13(2):67-72. DOI: 10.1053/j.nainr.2013.04.001 google scholar