Weight loss in newborns is a common phenomenon that occurs in the first days after birth. This early weight loss is considered normal as long as the baby regains back the weight by 10-14 days of age. However, excessive weight loss can potentially lead to complications and requires prompt evaluation and management.
Causes Of Newborn Weight Loss
There are several reasons why newborns lose weight in the initial days following birth:
- Fluid Loss: Babies lose extracellular fluid after birth leading to weight loss. The amniotic fluid they swallow in the womb gets cleared out.
- Insufficient Feeding: Many newborns do not get adequate breastmilk/formula in the first 2-3 days when the mother’s milk supply is still building up. This leads to calorie deficit causing weight loss.
- Birth Weight: Newborns with a higher birth weight tend to lose more weight in percentage terms compared to lower birth weight babies. However, low birth weight babies lose a higher proportion of their body weight.
- Illness: Some underlying illnesses like infections, birth defects, etc can lead to poor feeding and excessive weight loss.
- The passing of Meconium: Loss of weight occurs when the baby passes the sticky meconium stools after birth.
Normal Weight Loss Pattern
Healthy term newborns are expected to lose around 3-5% of their birth weight in the first few days. For babies with higher birth weight, a weight loss of 6-8% may also be considered normal. The maximum allowable weight loss is typically up to 10% of birth weight. Most babies start regaining the lost weight by 3-5 days and are back to their original birth weight by 10-14 days of age.
Concerns With Excessive Weight Loss
Some newborns can lose weight excessively due to various reasons like breastfeeding difficulties, illnesses, etc. More than 10% loss of birth weight raises concerns about dehydration, inadequate milk intake and other problems. Some risks associated with excessive weight loss include:
- Dehydration and electrolyte imbalance
- Increased risk of jaundice
- Hypoglycemia or low blood sugar
- Delay in regaining birth weight
- Impaired brain development
- Increased risk of infection
- Lethargy and poor feeding
If the baby loses more than 10-12% of birth weight, or does not start to regain weight by 10-14 days, further evaluation and assistance is required.
Management Of Excessive Weight Loss
If the newborn is losing weight excessively, the pediatrician will try to determine the underlying cause and manage accordingly:
- Assess breastfeeding technique and increase the frequency of feeding if required.
- Determine if the mother has a low milk supply and use techniques like power pumping to increase the supply.
- Give supplementary pumped breast milk or formula feeds.
- Check baby for illnesses like infection and manage them appropriately.
- Monitor hydration status and correct dehydration if present.
- Check for and treat low blood sugar if present.
- Consider medications to improve feeding like metoclopramide in some cases.
- Consider temporary use of feeding tube or supplemental nursing system.
- Hospitalization may be required in severe cases for close monitoring and intervention.
Preventing Excessive Weight Loss
Some measures that can help prevent excessive weight loss in newborns include:
- Early and frequent breastfeeding in first 24-48 hours of life
- Allow baby unlimited time at breast for feeding
- Wake baby to feed if long gap since previous feed
- Ensure proper latch and feeding technique
- Express breastmilk and feed supplementary expressed milk
- Give formula supplementation if indicated
- Seek lactation support for breastfeeding issues
- Check weight daily in first week to identify excessive weight loss
- Recognize signs of dehydration like fewer wet diapers
- Take help from a pediatrician at the earliest sign of inadequate feeding
With appropriate monitoring, early intervention, and supportive techniques, excessive weight loss can be managed well. Most babies who lose excessive weight in the initial days can regain it back with adequate feeding and care.
In summary, it is common for newborns to lose some weight in the first days after birth due to fluid loss, inadequate feeding, and other factors. A weight loss of up to 10% of birth weight is considered normal and is not a cause for concern in healthy-term babies.
However, excessive weight loss beyond 10% warrants further evaluation and intervention to prevent complications like dehydration, electrolyte imbalances, and impaired brain development. Close monitoring, frequent breastfeeding, expression of breastmilk, and formula supplementation if required can help manage excessive weight loss.
Maternal issues like inadequate milk supply and breastfeeding difficulties also need to be addressed. With prompt management, most babies who lose excessive weight are able to regain it back within the first 2-3 weeks.
Healthcare providers play a key role in identifying babies with excessive weight loss through daily weight checks in the first week and educating mothers on adequate feeding and monitoring for signs of dehydration.
Preventive strategies like unrestricted breastfeeding in the early days can reduce excessive weight loss. With appropriate care, support, and follow-up, newborns experiencing significant weight loss can get back on track with their growth and development.