title: [BREASTFEEDING PROBLEMS AND OTHER FACTORS ASSOCIATED WITH EXCESSIVE NEONATAL WEIGHT LOSS IN A SOCIAL SECURITY HOSPITAL IN LIMA, PERU].
abstract: BACKGROUND
  during the first days of life the mother is the main source of nutrients for the newborn. However, breastfeeding difficulties are common and may generate excessive neonatal weight loss.
  
  
  OBJECTIVE
  estimate the magnitude and association between breastfeeding problems and excessive neonatal weight loss beyond the physiological norm in the neonatology ward in a social security hospital in Lima, Peru.
  
  
  METHODS
  we conducted a cross sectional analysis of the recorded neonatal weight in a routine evaluation (between 24 and 72 hours of life) and compared it against birth weight. Excessive weight loss was defined as a difference greater than or equal to 7 %. Breastfeeding problems (defined as problems with breastfeeding initiation, mouth position, breastfeeding duration, breastfeeding frequency, too much clothing, nipple pain and C form) were investigated using a survey and visual verification. The association between excessive weight loss and breastfeeding problems, adjusted by other factors, was quantified using a multiple generalized linear model.
  
  
  RESULTS
  excessive weight loss was present in 18.8% (74/393) of the newborns. Improper positioning of the mouth on the nipple was present in 53.7% (211/393) of neonates while nipple pain was reported by 44.0% (173/393) of mothers. In the adjusted analysis, nipple pain [PR = 1.50 (95% CI: 1.02 to 2.22)] and improper positioning of the mouth [PR = 1.67 (95% CI: 1.09- 2.57)] were associated with an increased occurrence of excessive neonatal weight loss.
  
  
  CONCLUSIONS
  breastfeeding problems are common. These difficulties are significantly associated with an increased occurrence of excessive neonatal weight loss. Improvements in breastfeeding practices, for example through educational programs, may decrease the occurrence of excessive neonatal weight loss.
authors.affiliation: Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima.. caro_ba89@hotmail.com.
authors.forename: Melissa
authors.initials: M
authors.lastname: Berger-Larrañaga
authors.affiliation: Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima.. caro_ba89@hotmail.com.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bustamante-Abuid
authors.affiliation: Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima.. caro_ba89@hotmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Díaz-Vergara
authors.affiliation: Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima. Servicio de Neonatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.. caro_ba89@hotmail.com.
authors.forename: Julio
authors.initials: J
authors.lastname: Tresierra-Cabrera
authors.affiliation: Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima.. caro_ba89@hotmail.com.
authors.forename: Percy
authors.initials: P
authors.lastname: Mayta-Tristán
authors.affiliation: Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima.. caro_ba89@hotmail.com.
authors.forename: Eddy
authors.initials: E
authors.lastname: R Segura
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D010568:Peru / Q000453:epidemiology; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult