An observational study of associations among maternal fluids during parturition, neonatal output, and breastfed newborn weight loss

Abstract

BackgroundNewborn weight measurements are used as a key indicator of breastfeeding adequacy. The purpose of this study was to explore non-feeding factors that might be related to newborn weight loss. The relationship between the intravenous fluids women receive during parturition (the act of giving birth, including time in labour or prior to a caesarean section) and their newborn's weight loss during the first 72 hours postpartum was the primary interest.MethodsIn this observational cohort study, we collected data about maternal oral and IV fluids during labour or before a caesarean section. Participants (n = 109) weighed their newborns every 12 hours for the first three days then daily to Day 14, and they weighed neonatal output (voids and stools) for three days.ResultsAt 60 hours (nadir), mean newborn weight loss was 6.57% (SD 2.51; n = 96, range 1.83-13.06%). When groups, based on maternal fluids, were compared (≤1200 mls [n = 21] versus > 1200 [n = 53]), newborns lost 5.51% versus 6.93% (p = 0.03), respectively. For the first 24 hours, bivariate analyses show positive relationships between a) neonatal output and percentage of newborn weight lost (r(96) = 0.493, p < 0.001); and b) maternal IV fluids (final 2 hours) and neonatal output (r(42) = 0.383, p = 0.012). At 72 hours, there was a positive correlation between grams of weight lost and all maternal fluids (r(75) = 0.309, p = 0.007).ConclusionsTiming and amounts of maternal IV fluids appear correlated to neonatal output and newborn weight loss. Neonates appear to experience diuresis and correct their fluid status in the first 24 hours. We recommend a measurement at 24 hours, instead of birth weight, for baseline when assessing weight change. Because practices can differ between maternity settings, we further suggest that clinicians should collect and analyze data from dyads in their care to determine an optimal baseline measurement.

Excessive weight loss in exclusively breastfed full-term newborns in a Baby-Friendly Hospital

“…, 27 The infusion of 1.200mL to more than 2.500mL of fluids to the mother, at a cesarean section or vaginal delivery with analgesia,19 determines hypervolemia in newborns and increases diuresis on the first day of life 227 Much of the weight loss of these newborns is observed on the first day 2…”

“…, 27 The infusion of 1.200mL to more than 2.500mL of fluids to the mother, at a cesarean section or vaginal delivery with analgesia,19 determines hypervolemia in newborns and increases diuresis on the first day of life 227 Much of the weight loss of these newborns is observed on the first day 219 In a review of the subject19 evidence was found in eight studies that associated weight loss with excess fluids offered to the mother in exclusively breastfed newborns.…”

Mothers' Experiences with Baby Scales in the First Two Weeks Post Birth: A Qualitative Study

“…Noel-Weiss et al were aware of the controversy around routine newborn weight measurements [12]. The researchers were prepared to stop the study if the participants were distressed or showing signs that frequent weight measurements were influencing how they were managing breastfeeding (e.g., use of formula supplementation).…”

“…In a recent study about newborn weight loss [12], participants weighed their infants for 14 days as part of the data collection. Participants in the original study received a portable electronic baby scale, provided by the researcher, after the birth of their babies.…”

“…Participants were recruited from the newborn weight loss study [12], and potential participants were invited when the researcher phoned to complete the final questionnaire at two weeks postpartum. Informed consent was signed when the researcher picked up the baby scale from the participants' homes at two to three weeks postpartum.…”