The physiological weight loss of the newborn is. Physiological weight loss in newborns

If the pregnancy went without complications, the baby, most likely, immediately after birth will weigh 3-3.2 kg. But by the end of their stay in the maternity hospital, mothers notice that the baby has lost a little weight, because both indicators are recorded in exchange card issued at checkout. This difference involuntarily causes concern: after all, the pace of development of the baby depends on body weight. But in fact, there is no reason to worry. Such weight loss in the first days after birth is a natural process, which doctors call the physiological weight loss of the newborn, if, of course, it occurs within certain limits.

Limits of the norm

Weight loss is primarily associated with the loss of fluid through the skin and through the lungs during breathing. Besides, cord remnant dries up, urine and meconium (original feces) accumulated over time begin to stand out prenatal development child. And since the baby takes quite a bit more milk from the mother, the volume of fluid received by his body less than that the amount of moisture it gives off. The temperature and humidity of the air in the room where the baby is located also matters. Normal indicators 18−21 °С and about 70% are considered respectively. The higher the temperature and the lower the humidity, the more the baby sweats, and this contributes to weight loss.

Maximum weight decreases usually by the 3-5th day of life. Normally, the loss is from 5 to 10% of the initial body weight. So, if a newborn weighs 3 kg, normally he can lose weight by 150-300 g. But if the baby was born prematurely, then in the first days of life this figure can be up to 15% of the initial parameters. Children with extremely low body weight (less than 1 kg) sometimes lose weight by 18%. The boundaries are also pushed apart during prolonged childbirth or if the baby has received a birth injury.

One of the conditions quick recovery- early attachment of the baby to the breast. This can be done as early as 20 minutes after its birth.

Proper care

It is almost impossible to prevent newborn weight loss. But if organized proper care and establish breastfeeding, recovery will be faster, and weight loss will be minimal.

Healthy children recover quickly enough: already on the 6-8th, maximum 14th day of life, the baby will gain its previous weight. At normal care and breastfeeding, the baby will then begin to add from 125 g to 500 g per week. Prolonged recovery or too much weight gain indicate health problems, such as an infectious process or congenital disorders.

You should also follow drinking regimen. A child who is breastfed is supplemented with water if he has thick stool and he rarely urinates, also in summer when it is very hot outside. "Artists" additional drink is simply necessary. Between feedings, they must be offered plain boiled water.

So, your baby is born, and neonatologists tell you the height and weight of the newborn. But the readings of the scales during the daily examinations of the child by the specialists of the maternity hospital show that the baby is losing weight. The neonatologist should explain to you in detail why this is happening and reassure you that the process of loss is quite physiological and normal.

Why do children lose weight?

Getting into the extrauterine aggressive environment, the child goes through a rather difficult period of adaptation. Almost all vital processes now proceed differently than in the mother's stomach - the baby breathes with his lungs, his digestive and excretory system start their work.

In the process of adaptation, the newborn loses a lot of moisture, and mainly because of this, physiological weight loss occurs.

Moisture is spent on the following processes:

• humidification of the breath;
• excretion of meconium (first feces);
• urination;
• regurgitation;
• drying of the remnant of the umbilical cord.

Also, a large percentage of the fluid the newborn loses through the evaporation of moisture from the skin.

Replenishment of moisture loss occurs with the help of mother's milk or artificial mixtures. But since the mother does not yet have enough plentiful lactation, the volume of colostrum that the baby receives is not enough to equalize the loss and intake of moisture. In addition, the newborn is still learning to eat, and drinking a small amount of the first mother's milk, he gets tired and falls asleep. As a result, temporary dehydration occurs, and the baby loses weight.

What can aggravate weight loss?

Some children lose more weight than they should. This is due to the circumstances of childbirth, the lactation process and the conditions in the ward:

• premature babies take longer and more difficult to adapt to extrauterine existence;
• children born in prolonged labor;
• a long break between the discharge of the waters and the moment of the birth of the child;
• children with birth trauma;
• insufficient volume of colostrum in the mother;
• dry air in the room;
• heat air in the room;
• babies weighing more than 4 kg.

What is the normal rate of weight change in the first week?

The weight loss of the newborn is calculated as a percentage relative to the body weight recorded at birth. The maximum loss, as a rule, is noted on the 3rd-5th day of the child's life and is 10%. So, if a baby was born with a weight of 3600 grams, then its critical loss will be 360 ​​grams. If the weight of the baby does not fall below 3240 gr. and on the 5th-6th day he will begin to gain it, so everything is fine with him.

As a rule, if the volume of colostrum or formula for the child is sufficient, it will not approach critical numbers, and the percentage of weight loss will be only 6-8%. At favorable conditions mass gain will begin quite quickly, and on day 6-7 the decrease will be restored by 80%.

At premature babies, as well as newborns weighing more than 4 kg, the rate of recovery of lost body weight is somewhat slower.

How to help?

You can help the newborn and create conditions that will reduce moisture loss, and as a result, weight loss.

1. If possible, create in the room in which you are with the baby, optimal temperature conditions(22-24 degrees).
2. If the air is too dry with heating devices, humidify it using a special device or by placing a container of water by the crib.
3. Breastfeed your newborn more often to encourage lactation and avoid severe weight loss in the baby.
4. Do not wrap up the baby and check by feeling his neck if he is hot, because sweating will increase the loss of moisture.

Further weight gain

At routine examinations by a pediatrician from a month to a year, the child will be regularly weighed on a scale. The doctor will compare early data from the maternity hospital, take into account the weight loss of the baby after birth and its subsequent increase in co. They indicate the norm, how much the baby should add to his weight for a certain period.

Pediatricians rarely have claims to artificialists, since such children eat a certain amount of the mixture, which can be visually controlled. Breastfed Toddlers Get Sucked Out maternal breast unknown volume of milk. Moms, along with doctors, can judge whether it is enough by weight gain or loss, as well as general condition child. That is why regular weighing of the baby's body up to a year is so important.

If your baby is slightly ahead of his peers in terms of weight gain, or the doctor determines that you are underweight, do not be discouraged. The pediatrician will advise you on how to adjust the feeding process so that the child's weight returns to normal. You may need to weigh your child before and after meals to find out how much milk he is drinking and write these numbers down. You will show the received data to the pediatrician. If the shortage is due to a lack of a product of your lactation, the doctor will recommend that you feed your baby more often to increase it, or decide on supplementing the baby with formula.

But not always weight loss occurs due to lack of mother's milk:

1. A slight lack of body weight may be associated with hereditary factors: one of the relatives of the child could grow and gain weight for up to a year not as intensively as their peers; in addition, if the child has miniature parents, you should not expect him to quickly gain weight.
2. Children under one year old develop in leaps and bounds, they can show a shortfall on the scales for some time, and then “overfulfill” the plan, such uneven weight gain, as well as growth closely related to it, is a physiological norm.

Increase rates

In 2004, the WHO released growth and weight gain tables for children. It differs from the previous version in that it slightly differs in the rate of development of artificers from the rate of babies in breastfeeding.

In the first six months, the rate of increase in a child averages 600-800 grams per month. Further, due to the growth physical activity, the baby will gain weight more slowly - about 400 grams per month up to a year.

If in one of the first 4 months the weight gain is less than 500 grams, there is a clear shortage, the doctor will definitely recommend supplementing the child, indicate how much it should be in volume, and select the appropriate one. There is no need to wait for everything to work out by itself - any problems in the nutrition and development of a baby up to a year will inevitably affect his health.

From the age of five months, the baby moves more actively, and this consumes quite a lot of energy received from food. Small failures and underweight during this period are the physiological norm.

When your baby finally comes into this world, then you, along with the news of his birth, are happy to tell all relatives and friends two important numbers - the baby’s height and body weight (or, as is customary for most, weight). However, by the time of discharge from the hospital, the weight of the baby in most cases decreases slightly. This means that a characteristic of the neonatal period has occurred. physiological loss body weight. What is it and is it worth worrying if the baby has lost a little weight?
Normally, a decrease in body weight should not exceed 5-8% of the weight at birth. That is, if the baby weighed 3000 g at birth, then a physiological loss of up to 240 g is quite acceptable. With greater weight loss, the doctor must take all necessary measures to prevent further weight loss. The maximum weight loss is observed in most full-term newborns on the 3-5th day of life, the restoration of body weight occurs 6-12 days after birth. At premature babies weight loss also depends on birth weight, but it is restored only by the second or third week of life, and even then not in all newborns.
There are three degrees of loss of the initial body weight of the newborn:

• first degree (weight loss is less than 6% of birth weight). In this case, the child does not show signs of dehydration, but there may be greed during feeding, anxiety. At the cellular level, laboratory studies reveal minor signs of intracellular hypohydration. Most newborns belong to this group.
• second degree (newborn weight loss within 6-10%). In this case, some signs of dehydration may appear: thirst, brightness of the mucous membranes, pallor of the skin, increased heart rate, shortness of breath, irritability is noticeable in the child's behavior. IN laboratory conditions there are signs of intracellular hypohydration and extracellular dehydration.
• third degree (weight loss more than 10%). In this case, signs of dehydration are more pronounced: intense thirst, dry mucous membranes and skin, shortness of breath, severe tachycardia, fever, the child behaves restlessly or inhibited. Laboratory observed pronounced signs of intracellular and extracellular hypohydration.

Loss of more than 10% of body weight can lead to a significant deterioration in the child's condition, so the doctor individually decides whether additional supplementation or formula feeding is necessary.
Let's see what can cause weight loss: dehydration due to significant energy costs of the body. Indeed, in the first days of life, the child receives very a large number of colostrum - from a few drops to several milliliters, while consuming a significantly larger amount of energy. In addition, some children suckle very sluggishly in the first days, which also contributes to a longer lactation and, accordingly, slows down the rate of weight gain in the baby; fluid loss associated with evaporation through the skin; fluid loss associated with the excretion of urine and meconium (this is the original feces - a dark-colored mass formed from swallowed by the baby amniotic fluid and secretions digestive system); prerequisites for the expressed more weight loss can be prematurity of the baby, birth weight more than 4 kg, complex or prolonged labor, early departure amniotic fluid, the presence of birth trauma.
Prevention of excessive weight loss in the newborn can be early attachment to the breast, free mode breastfeeding, rational temperature regime in the room where the child is.

Found in 100% 2-4 days of life and is normal 5 – 7 - 8% (up to a maximum of 10%) loss from birth weight (in preterm 9-14%). Recovery body weight by 7-10 days(for premature babies 2-3 weeks).

CAUSES:

Malnutrition in the early days

Excretion of water through the skin and lungs

Loss of water in urine and feces (meconium)

Insufficient fluid intake

Regurgitation of amniotic fluid

Drying out (drying out) of the umbilical cord residue

Early application to the chest

Feeding on demand

Prevention of hypogalactia

Body weight control

2. Physiological catarrh of the skin (transient erythema of the skin).

It appears as:

1. simple erythema

2. toxic erythema

SIMPLE erythema.

This is a reactive redness of the skin (sometimes with a slight bluish tint to the hands and feet).

CAUSE: reflex paretic vasodilation of the skin due to the powerful influence of environmental factors on the skin receptors of the newborn.

Appears in first days of life, in mature full-term babies it lasts several hours, less often 1 - 2 - 3 days.

toxic erythema.

This is a kind of allergic reaction of the skin of a newborn.

Arises on the 2nd - 5th day of life. It manifests itself in the form of a rash - hyperemic spots, papules, vesicles on the entire skin, except for the palms and feet. Disappears in 2-3 days. After erythema, there is a small peeling, sometimes large.

TACTICS midwife (nurse, paramedic):

Skin care

Hygiene bath with potassium permanganate solution

3. Physiological (transient) fever.

CAUSES:

Imperfection of thermoregulation

Insufficient fluid intake in the body

Unsustainable water exchange

Child overheating

Entry of E. coli endotoxins during the initial colonization of the intestine

Appears on the 3rd - 5th day of life. Disappears after a few hours or 1-2 days.

SIGNS: T 38-39 degrees, anxiety, thirst, dry skin and mucous membranes.

TACTICS midwife (nurse, paramedic):

Reveal baby

Body temperature control, condition

4. Physiological (transient hyperbilirubinemia) jaundice.

CAUSES:

Immaturity of liver enzyme functions

Massive destruction of fetal red blood cells (there are many in the fetus)

Elevated levels of bilirubin in the blood

RBC pigment accumulates in the skin and mucous membranes, stains yellow

Appears for 2 - 3 days, for a maximum of 4-5 days. Disappears by 7-10 days of life.

SIGNS: icteric coloration of the skin and mucous membranes without disturbing well-being.

TACTICS midwife (nurse, paramedic):

Additional drink of 5% glucose solution

Monitoring the child's condition

5. Hormonal (sexual) crisis.

CAUSE: the transition of mother's estrogens into the blood of the child and with milk

SIGNS:

1. PHYSIOLOGICAL MASTOPATHY(in boys and girls) - symmetrical engorgement of the mammary glands without signs of inflammation. There may be a grayish discharge from the nipples.

Appears on the 3rd - 4th day of life,disappears by the end of 2-3 weeks.

2. SWELLING OF THE SCROTUM in boys, symmetrical changes appear in the first days of life, disappear without treatment by the 3rd day of life.

3. Desquamative Vulvovaginitis in girls - gray-white, sometimes brown discharge from the genital slit, appear on the 1st day of life, disappear by the 3rd day.

TACTICS midwife (nurse, paramedic):

When engorgement of the mammary glands - gentle care (do not injure this area)

Dry heat on the area of ​​glands

For vulvovaginitis - washing girls

6. URINARY ACID INFARCTION OF THE KIDNEYS.

This deposit uric acid in the form of crystals in the lumen of the urinary tubules.

CAUSES:

Passing a small amount of urine

Increased breakdown of a large number of cells

Features of protein metabolism

SIGNS:

Change appearance urine (cloudy, yellowish Brown), after drying, brown spots and sand remain on the diapers

Decrease in the daily volume of diuresis (physiological oliguria).

Appears on the 3rd - 4th day of life, disappears after 7 - 10 days(with increasing diuresis and washing out of crystals)

TACTICS midwife (nurse, paramedic):

Additional drink of 5% glucose solution

FEATURES OF PHYSIOLOGICAL STATES IN PREMATURE CHILDREN.

1.Physiological loss body weight- 9 -14%, weight loss is extended over time, recovery by 2 - 3 weeks of life

2. Physiological jaundice- occurs more often than in full-term (59 - 90%), the content of bilirubin is higher (85 μmol / l), slower accumulation of bilirubin, slow maturation of enzyme systems creates a threat of bilirubin intoxication.

Nuclear jaundice can be with indirect bilirubin 170 µmol/l; the decrease in bilirubin is slow, jaundice lasts 2 weeks or more.

3. Physiological erythema(toxic) lasts a long time.

4. Hormonal crisis practically not observed.

5. Transient hypothyroidism.

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Weight and height are the main indicators at the birth of a child. When discharged from the hospital, the weight of the baby may decrease, which is quite natural for the neonatal period. The weight loss of the baby worries parents, grandmothers and other relatives. But not a neonatologist, because he knows causes of weight loss, and explains them to excited moms and dads.

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Physiological weight loss

If weight loss does not exceed 8% of the child's birth weight, then there is no cause for concern. On the 3-5th day of a child's life, maximum loss body weight, but a week after his birth, the weight begins to recover. Concerning premature babies, then their body weight is restored by the end of the second or third week.

Weight loss is caused by loss of fluid through the skin and lungs, excretion of urine and intestinal contents accumulated over intrauterine period development. The baby in the first days of life consumes only a few milliliters of colostrum, and the discrepancy between the amount of fluid consumed and excreted by the body leads to weight loss. A newborn consumes a large amount of energy, which also affects body weight. After 10-14 days, a breastfed baby will receive required amount milk, and add from 130 to 500 g per week.

Factors Influencing Rapid Weight Loss

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Significant weight loss is observed in children born before due date. It is difficult for such children to adapt to environment. Babies born weighing over 4 kg also lose more weight. Protracted labor, early discharge of amniotic fluid or birth trauma lead to large weight loss.

The rapid decrease in body weight is affected by hypogalactia (reduced amount of milk) in the mother. In the first days of life, most newborns breastfeed sluggishly, which slows down the process of lactation, and this in turn leads to weight loss. dry air and fever in the room where the child is located, also contributes to rapid weight loss.

Signs of dehydration

If the decrease in body weight is up to 10% of the initial indicator, then the following signs of dehydration appear:

- the baby is thirsty;

- mucous membranes bright shade;

- the skin is pale;

- palpitations and shortness of breath;

The child is restless and irritable.

With more high rates weight loss signs of dehydration are expressed as follows:

- mucous membranes and skin are dry;

- retraction large fontanel;

- tachycardia and shortness of breath;

- increased body temperature;

- restless state is replaced by lethargy.

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Prevention of significant weight loss

So that weight loss does not exceed natural physiological level, it is necessary to observe the optimal temperature regime of the room in which the baby is located. It is necessary to dress the child in accordance with the air temperature. Optimum temperature air in the children's room 22-24 degrees. Dry air in the room can be humidified with a special device or a container of water placed not far from the baby's crib. Loss of fluid disrupts heat transfer and leads to dryness of the mucous membranes, and this weakens the defense mechanism against possible infection. To protect the newborn from the penetration of pathogenic bacteria, it is necessary to carry out wet cleaning in his room daily, wiping not only the floor, but also the furniture. Early breastfeeding and free breastfeeding are excellent prevention of excessive weight loss.

If the indicators exceed all permissible norms, in this case, you should immediately consult a doctor, since such a condition may indicate congenital pathology or the presence of an infection.

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