title: First-day newborn weight loss predicts in-hospital weight nadir for breastfeeding infants.
abstract: BACKGROUND
  Exclusive breastfeeding reduces infant infectious disease. Losing > or =10% birth weight may lead to formula use. The predictive value of first-day weight loss for subsequent weight loss has not been studied. The objective of the present study was to evaluate the relationship between weight loss at <24 hours and subsequent in-hospital weight loss > or =10%.
  
  
  METHODS
  For 1,049 infants, we extracted gestational age, gender, delivery method, feeding type, and weights from medical records. Weight nadir was defined as the lowest weight recorded during birth hospitalization. We used multivariate logistic regression to assess the effect of first-day weight loss on subsequent in-hospital weight loss.
  
  
  RESULTS
  Mean in-hospital weight nadir was 6.0 +/- 2.6%, and mean age at in-hospital weight nadir was 38.7 +/- 18.5 hours. While in the hospital 6.4% of infants lost > or =10% of birth weight. Infants losing > or =4.5% birth weight at <24 hours had greater risk of eventual in-hospital weight loss > or =10% (adjusted odds ratio 3.57 [1.75, 7.28]). In this cohort, 798 (76.1%) infants did not have documented weight gain while in the hospital.
  
  
  CONCLUSIONS
  Early weight loss predicts higher risk of > or =10% in-hospital weight loss. Infants with high first-day weight loss could be targeted for further research into improved interventions to promote breastfeeding.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, 94143-0503, USA. FlahermanV@peds.ucsf.edu
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Flaherman
authors.forename: Seth
authors.initials: S
authors.lastname: Bokser
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Newman
mesh_terms: D001942:Breast Feeding / Q000453:epidemiology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D041943:Infant Formula / Q000008:administration & dosage; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D049590:Postpartum Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology*