Primary Newborn Weight Loss in Conjunction with Baby Friendly (Evidence Based) Practices

Purpose:
To identify average weight loss in term newborns in conjunction with evidence based practices.The Baby Friendly Initiaive includes ten steps supporting normative birth and post partum practices. These steps also increase exclusive breastfeeding (now a Joint Commission peri- natal core measure)

Background/Significance:
Early infant weight loss has been used as a measure of effective feeding.A total loss of 7-10% is deemed“average” Infant weight loss increases when infants are stressed.Stressors include separation, hospital interventions and supplementation with infant formula. Evidence based "Baby Friendly” practices decrease stressors for the infant and support normative breast feeding behaviors Accepted newborn weight loss may be an overestimate since Baby Friendly practices are the biological norm

Methods:
This is a retrospective study of 400 newborns(term infants 38 weeks or greater)1 year before"Baby Friendly Practices" and a second sample of 400 infants(38 weeks or greater) 1 year after Baby Friendly practices were compared using birth weight,% weight loss at day 2.Also type of birth, type of feeding (BB=Exclusive breastfeeding, BF=combination feeding and FF=Formula feeding)was also identified.An independent t-test was run to examine the differences in mean weight loss in breast fed (BF), formula fed (FF) and babies who were both breast and formula fed (BF) before and after Baby Friendly practices. Infants born by C- section were also examined using the same methods

Results:
There was a significant decrease in percent weight loss for Day 0 to 2 in BF (p < .05) after the initiation of Baby Friendly practices. The decrease was not significantly different in FF or BFF (p >.05). In women with C-section delivery,There was a significant decrease in percent weight loss for Day 0 to 2 in BF babies delivered via C-section (p < .05) after the initiation of Baby Friendly practices. The decrease was not significantly different in FF or BFF (p >.05) among C-section babies or in any group among babies delivered vaginally.

Conclusions and Implications for Practice:
Facilities and practictioners need to re-examine areas of newborn and maternal care that are not research based. These practices promote a stress response in infants and mothers.The Baby Friendly Initiative is the standard for newborn care;the US must embrace these practices for healthier outcomes