title: Study of Weight Patterns in Exclusively Breast Fed Neonates- Does the Route of Delivery have an Impact?
abstract: BACKGROUND
  Physiological weight loss is seen in all breast fed neonates. The route of delivery may have an effect on the neonatal weight loss/gain in these exclusively breast fed babies. Additional assistance and support for exclusive breast feeding is needed by mothers who undergo cesarean section.
  
  
  OBJECTIVE
  To study and compare the weight patterns in full term exclusively breast fed neonates born by normal vaginal route versus cesarean section in the first month of life.
  
  
  METHODS
  It is a prospective observational study. Healthy, full term neonates born by normal vaginal route or cesarean section in a rural tertiary hospital with uneventful perinatal periods were included. Exclusive breast feeding was given to all neonates with supervision and encouragement to the mothers. Primary outcome measure- Weight loss of the neonates at 24 hours and 72 hours of life.
  
  
  RESULTS
  Neonates delivered by cesarean section showed a higher weight loss (% of birth weight) at 24 hours {mean(sd)} than those delivered vaginally {3.2 (1.9) vs 2.2 (1.2); p-value=0.0016}. At 72 hours, the cesarean neonates had higher weight loss than vaginally delivered neonates {5.9 (3.1) vs 4.7 (2.5); p-value=0.0314}. At 28 days of life, the neonates born by cesarean section showed lower weight gain than those delivered by vaginal route {10.9 (2.1) vs 11.9 (2.3); p-value=0.0244}.
  
  
  CONCLUSIONS
  The route of delivery has a significant impact on the physiological weight loss seen in exclusively breast fed neonates. Babies delivered by cesarean section showed significantly higher weight loss in the first week of life, and lower weight gain at the end of first month than babies born by vaginal route.
authors.affiliation: Associate Professor, Department of Pediatrics, BGS Global Institute of Medical Sciences , Bangalore, India .
authors.forename: Purnima
authors.initials: P
authors.lastname: Samayam
authors.affiliation: Post Graduate, Department of Pediatrics, MVJMC & RH , Hoskote, Bangalore, India .
authors.forename: Pradeep Krishna
authors.initials: PK
authors.lastname: Ranganathan
authors.affiliation: Head of Department, Department of Pediatrics, MVJMC & RH , Hoskote, Bangalore, India .
authors.forename: Ravichander
authors.initials: R
authors.lastname: Balasundaram
keywords: Breast feeding; Cesarean section; Newborns; Weight loss