Neonate weight gain/loss

Question 1

normal weight gain

Answer 1

first days ~ may lose 5-8% of birth weight
2 weeks breastfed infants return to birth weight
should be gaining 0.5-1 oz daily
3 weeks ~ criteria for FTT is lack of return to birth weight
5-6 months ~ usually double birth weight
1 year~ usually triple birth weight

Question 2

signs and symptoms of healthy breastfed infants

Answer 2

• active and alert state
• developmentally appropriate progress
• age appropriate height and head circumference
• good skin turgor and color
• sufficient output of at least 6 diapers a daybed 4 days of life
• contented and satisfied behavior after feedings

Question 3

signs baby is going through growth spurt

Answer 3

hungrier than usual
sleeps more than usual
grumpier than usual
average ages for growth spurts= first few days home, 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 7-9 months

Question 4

contributing factors to poor weight gain in newborn

Answer 4

infrequent or inadequate feedings
inadequate milk production
genetic predisposition
infection
organic disease
physical anomaly that prevents good suck and swallow like cleft palate

Question 5

Clinical findings/infant factors for poor weight gain

Answer 5

• continued weight loss after 5-7 days
• failure to regain birth weight by 2-3 weeks
• failure to maintain ongoing weight gain of 0.5-1 oz daily
• weight below the 3rd percentile
• lethargic, sleepy, inactive, unrepsonsive
• sleeping more than 4 hrs between feedings ~ one five hr stretch at night may be normal
• dry mucous membranes
• poor skin turgor

Question 6

What clinical findings / technique factors could be found for poor weight gain in newborn?

Answer 6

• ineffective latch or sucking
• short time at breast ( reduces hind milk consumption)
• preset schedule that ignores hunger cues
• giving water between feedings
• infant allowed or encouraged to sleep through the night before 8-12 weeks old
• fewer than 8 feedings in 24 hrs for breastfeeding
• infant fed in distracting environment

Question 7

What clinical findings/ maternal factors can be seen for poor weight gain in newborn?

Answer 7

• does not respond to or recognize the infant’s hunger cues
• hectic schedule with limited time for breastfeeding
• recent illness with weight loss
• uses of coc’s or other hormones

Question 8

Acceptable weight loss for breastfed babies

Answer 8

10-12% with breastfed babies with no other clinical findings

Question 9

Complications of poor weight gain

Answer 9

• developmental delay
• poor bonding
• severe dehydration

Question 10

Management of poor newborn weight gain

Answer 10

• refer for treatment for physical or organic cause
• any infant who has lost weight and is unable to feed with vigor needs immediate referral to an acute care center for hydration/infusion
• use a supplemental nursing system at the breast if supplementation is required