title: Weight loss in exclusively breastfed infants delivered by cesarean birth.
abstract: BACKGROUND
  Rates of exclusive breastfeeding during the postpartum hospital stay are a key measure of quality maternity care. Often, however, concern for excessive in-hospital weight loss leads to formula supplementation of breastfed infants. The American Academy of Pediatrics defines 7% weight loss as acceptable for breastfed newborns regardless of mode of delivery. Typical weight loss in exclusively breastfed infants delivered by cesarean birth has not been studied nor have possible correlates of greater weight loss in this population.
  
  
  OBJECTIVE
  To determine average weight loss in a cohort of exclusively breastfed infants delivered by cesarean birth and to identify correlates of greater than expected weight loss.
  
  
  METHODS
  We performed a retrospective chart review of exclusively breastfed infants delivered via cesarean birth at a Baby-Friendly hospital between 2005 and 2007. Average weight loss was calculated, and multivariate regression analysis was performed.
  
  
  RESULTS
  Average weight loss during the hospital stay in our cohort of 200 infants was 7.2% ± 2.1% of birth weight, slightly greater than the American Academy of Pediatrics guideline of 7%. Absence of labor prior to delivery was significantly associated with a greater percentage of weight loss (P = .0004), as were lower gestational age (P = .0004) and higher birth weight (P < .0001). Maternal age, gravity, parity, infant sex, Apgar scores, and prior cesarean birth were not significantly associated.
  
  
  CONCLUSIONS
  We conclude that for exclusively breastfed infants delivered by cesarean birth in a Baby-Friendly hospital, absence of labor prior to cesarean birth may be a previously unreported risk factor for greater than expected weight loss.
authors.affiliation: Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts 02118-2392, USA. genevieve.preer@bmc.org
authors.forename: Genevieve L
authors.initials: GL
authors.lastname: Preer
authors.forename: P K
authors.initials: PK
authors.lastname: Newby
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Philipp
mesh_terms: D000328:Adult; D001724:Birth Weight; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D015431:Weight Loss