Physiological weight loss of the newborn as a percentage. Transient states of newborns

The most intensive development of the child occurs in prenatal period and during his first year of life.

Newborn children have some peculiarities in weight gain, since they, during the first week of life, have a physiological loss of body weight.

What is this physiological loss or weight loss in a newborn and what is it associated with? Here FAQ that excite young mothers. Let's talk about this in more detail.

Newborn weight gain

The loss of the initial body weight in newborns occurs mainly due to a slight starvation in the first days of life (since the mother’s milk is just beginning to come) and due to imperceptible loss of water through breathing and sweat. The excretion of urine, meconium, falling off of the umbilical cord, are also attributed to the causes of a decrease in the body weight of a newborn.

Physiological weight loss is observed in all newborns and does not depend on body weight at birth.

The maximum decrease in the initial body weight of the child usually occurs on the 3rd-5th day. It is measured as a percentage of body weight at birth.

Normally, the maximum loss of body weight should not exceed 10%. In healthy full-term newborns, it is usually no more than 6%. Losses of more than 10%, in a full-term newborn, indicate the presence of any diseases or violations in nursing the child.

Factors Contributing to Large Values maximum loss body weight:

1. prematurity;
2. Large body weight at birth (more than 4 kg);
3. Birth injury;
4. protracted childbirth;
5. Maternal hypogalactia;
6. High temperature in the newborn room;
7. Insufficient air humidity in the newborn room.

Smaller amounts of physiological weight loss are usually:

• In girls;
• In children with clinical manifestations of a hormonal crisis;
• In children born during repeated births;
• Attached to the mother's breast in the first 2 hours of life;
• In newborns who are on the "free feeding" regimen.

In healthy full-term newborns, 3 degrees of maximum weight loss are distinguished.

I degree - with a weight loss of less than 6%. At this degree clinical manifestations no dehydration. There may be some greed when sucking. But in laboratory parameters there may be signs of intracellular hypohydration (dehydration). This is an increase in the concentration of sodium in plasma, potassium in erythrocytes, high values ​​of the potassium-nitrogen coefficient of urine. But, as a rule, these indicators are not determined in healthy newborns, so these changes in the body remain unnoticed. Do not worry, as they do not affect the health of the baby.

II degree - with a loss of body weight of 6-10%. Clinical manifestations may either be absent, or the child may have thirst, anxiety, irritable cry. Other symptoms are the brightness of the mucous membranes, the slow spreading of the skin fold, tachycardia, shortness of breath. Laboratory data indicate intracellular and extracellular hypohydration - this is an increase in hematocrit, total protein serum levels, oliguria (decreased amount of urine), increased relative density urine.

III degree - weight loss of more than 10%. Clinically, the child has thirst, severe dryness of the mucous membranes and skin, skin fold unfolds very slowly large fontanelle sinks, tachycardia, shortness of breath, there may be an increase in body temperature, anxiety, tremor. In some children, on the contrary, adynamia is noted (decrease in motor activity), a decrease in reflexes, up to their complete extinction, marbling of the skin. Laboratory data indicate pronounced signs of intracellular and extracellular hypohydration - a significant increase in the level of sodium in the blood, thickening of the blood (increased hematocrit), an increase in total plasma protein. There is also oliguria and an increase in the relative density of urine.

Prevention of dehydration in physiological weight loss

Rational organization of newborn care and breastfeeding- early breastfeeding followed by breastfeeding every 2-2.5 hours (or free-feeding regimen);

Temperature regime(do not allow the child to overheat);

With the appearance of clinical manifestations, with a daily loss of body weight of more than 4%, with overheating of the child, with the identification of laboratory signs of dehydration, it is advisable solder the child between feedings of 5% glucose (or 5% glucose in half with Ringer's solution).

Restoration of body weight in a newborn

After a transient (physiological) loss, restoration of body weight at birth in healthy newborns usually occurs by the 6-7th day of life. In some children, the necessary weight gain may be delayed until the second week of life.

At premature babies, especially with grades 3-4, as well as in children with large body weight at birth, recovery of body weight is slower.

Optimal thermal conditions, timely detection and elimination of hypogalactia, earlier breastfeeding, proper care for the baby, here are the main factors that contribute quick recovery normal weight body.

Weight gain in infants by month

The rate of weight gain for a newborn in the first month of life is on average 600 grams.

2 month - 800 grams

3 month - 800 grams

4 month - 750 grams

5 month - 700 grams

6 month - 650 grams

7 month - 600 grams

8 month - 550 grams

9 month - 500 grams

10 month - 450 grams

11 month - 400 grams

12 month - 350 grams

The weight of the baby by 11-12 months of life increases by about 3 times. At one year old, a baby, on average, weighs 10-11 kg.

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Every newborn baby loses weight after birth. Of course, the weight loss of a newborn in the first days after birth is of great concern to many new parents. In order not to worry, you need to have an idea of ​​what kind of weight loss in a newborn is the norm, and what kind of pathology.

In the medical documents of a newborn baby, two weight indicators are recorded, the one with which he was born and the one with which he is discharged from the hospital. The second indicator, as a rule, is slightly lower than the first. This is due to the fact that a natural process occurs with the newborn, which leads to a slight weight loss and this loss is not a pathology. In the event that weight loss is within the normal range, then such a loss in medicine is called the physiological weight loss of the newborn.

What are the causes of newborn weight loss? First of all, this is due to the fact that the baby loses fluid through the skin and lungs when breathing, excreting urine and meconium, as well as drying out. umbilical cord. Because the newborn this stage receives from mother a small amount milk, then there is some discrepancy between the amount of fluid received and excreted by the body of the baby. A huge role in the loss of fluid by the baby is played by the temperature and humidity of the air in the room.

As a rule, on the third day after birth, the newborn experiences maximum weight loss. Normal limits of weight loss are within no more than 5-10% of body weight at birth. For example, if on average a newborn baby weighs 3.5 kg at birth, then a loss in the range of 75-350 g will be considered normal weight loss.

In the event that there were premature birth, then the weight loss of the newborn can reach up to 15% of the initial body weight. The reason for a greater reduction in the weight of the baby may be prolonged labor, birth trauma, complications in childbirth, or the birth of a baby with a large body weight. Some experts believe that pathological weight loss newly born the baby occurs mainly due to birth stress or improper care behind child com.

Parents need to remember that newborn weight loss does not depend on the sex of the child.

When the weight of the newborn should recover and return to normal? In most cases, the restoration of the original body weight, which was recorded at birth, in healthy children occurs closer to 7-10 (maximum 14) days of life.

If the newborn is on normal breastfeeding, then in the first two weeks of life he should regain weight and gain an additional approximately 125-500 grams.

Parents should be alert when a newborn child loses significant weight or when the recovery of the initial body weight of the child is delayed. This may be due to the presence of health problems in the child or may indicate a congenital pathology.

How to prevent pathological weight loss of a newborn baby? To do this, it is necessary to organize and plan the care of the baby as correctly as possible, to ensure optimal temperature regime, and also adjust, if necessary, crumbs, drinking regimen. In order for the weight loss of the newborn to be negligible, it is very important to ensure that he is previously attached to the breast and, best of all, if this happens no later than 20 minutes after birth.

In addition, sufficient air humidity in the room where the newborn is located is of great importance, since the drier the air in the room, the more moisture the baby will lose through breathing and through the skin. Do not forget that the loss of fluid can lead to a violation of heat transfer in the baby, dryness skin, mucous membranes of the nose, mouth, lungs, as well as to a violation of the mechanisms of protection of the body against viruses and bacteria.

That is why it is necessary to make every effort to ensure that the temperature in the children's room is at the level of 22-24 ° C, and the air humidity is at least 50%.

What can a mother outshine the joy of the birth of a baby and the expectation of being discharged from the hospital? News that her baby is losing weight!

This phenomenon seems unnatural and dangerous. Is it worth worrying? But how, because all the attention of parents and their relatives is riveted to the two most important figures - the height and weight of the child!

Some mothers, worried about the baby's weight loss and believing that the problem is a lack of milk, refuse breastfeeding before they get it right. Is it worth talking about the harm from actions caused by far-fetched fears?

What is physiological weight loss

In the first 3-5 days after birth, your baby loses weight - the so-called physiological weight loss occurs.

And this is a completely natural phenomenon, if the weight loss does not exceed the norm.

The norm is a decrease in body weight by 5-8% of the weight with which the child was born. For example, if your baby was born at 3500 g, then a physiological loss of up to 280 g is considered normal. Critical weight loss occurs on the 3-5th day of the baby's life, and already 6-12 days after birth, body weight is gradually restored.

In premature babies, physiological loss lasts longer, and such newborns lose more - from 9 to 14%. Weight is restored only in the second, and even in the third week of life.

If the baby does not have physiological loss body weight, this is where you should worry!

This indicates fluid retention in the child's body, which is most likely associated with pathology. urinary system. You can't do without consulting a doctor!

Three degrees of loss of the initial mass of the newborn

1. First degree.

   Weight loss is less than 6%. The child suffers from mild dehydration, which can be expressed in mild restlessness and greed during feeding. This group includes the majority of newborns who were born healthy.

2. Second degree.

   Weight loss within 6-10%. At the same time, the child behaves restlessly, shows thirst. He has a bright mucous membrane, pale skin, rapid heartbeat and breathing.

Third degree.

More than 10% weight loss. The child feels intense thirst, he has dry mucous membranes and skin, palpitations, shortness of breath, and even a fever. He can be both restless and sluggish.

In this case, the doctor determines the causes of sudden weight loss and makes recommendations for their elimination.

Causes of weight loss in a newborn in the first days of life

1. During birth, the baby's metabolism increases, which consumes a large amount of energy. The baby needs time to get used to extrauterine existence.

   In his mother's tummy, he received everything he needed through the umbilical cord. After birth, he has to learn a lot - breathe with his lungs, adapt to a new type of digestion.

   For small organism this is an additional load that takes an incredible amount of strength into the baby. And this is not an exaggeration, sucking is serious work for a child. Observant mothers may notice droplets of sweat on the skin of a newborn during feeding.

2. Insufficient replenishment of the body with fluid.

   Mom's lactation is just getting better. In addition, in the first two days, the baby sucks sluggishly and, accordingly, receives little milk.

   Some maternity hospitals give newborns extra water to prevent dehydration, but this preventive measure interferes with normal lactation and is criticized by breastfeeding experts.

3. The body of a newborn in the first days of life loses a lot of water:

• Most of the fluid is lost through the skin (about 60-70% of the lost mass). If the room air is dry or heat, which exacerbates the situation.
• The newborn begins to breathe on his own, and when breathing, as you know, moisture is released from the body.
• The umbilical cord residue slowly dries up.
• Promotes fluid loss urination and excretion of meconium (original feces).
• Minus in weight is complemented by regurgitation.

Which kids lose the most weight?

Infants with large body weight.

Children born with caesarean section or due to prolonged labor.

Premature and immature newborns.

It is much more difficult for such crumbs to adapt to new living conditions, so weight loss and its recovery take much longer.

How to help your baby regain weight faster

1. Don't neglect early attachment of the baby to the breast. After childbirth, the mammary glands produce colostrum - a viscous fluid yellow color containing great amount nutrients.

   Even a few drops of this valuable substance fills the body of a newborn with the necessary energy, helps him quickly adapt to a new environment.

   For the mother herself, early attachment ensures stable lactation, since emptying the breast is essential component lactation, and stagnation of secretion in the alveoli and ducts causes its oppression.

2. Choose a free mode for the newborn breastfeeding. In this mode, you feed the child not strictly by the hour, but when he asks.

   And it's good for mommy frequent application supports lactation, relieves the feeling of fullness in the chest.

3. Keep your child at the optimum temperature.

   In the children's room, keep the temperature no more than 22-24 ° C, and dress the child in accordance with the air temperature.

4. Do not overdry the air in the room. Humidify it with special devices or place a bowl of water near the baby's crib.

   The most common cause of dry air can be an oil heater.

Have you made sure that there is no reason to panic due to weight loss in a newborn in the first days of his life? If the answer is YES, then fine, because a calm mommy is a calm and healthy baby!

- various transient changes in the skin, mucous membranes and internal organs, developing in a child in the first days after birth and reflecting the physiological restructuring of the body. TO border states newborns include a birth tumor, simple and toxic erythema, skin peeling, milia, physiological mastopathy, physiological vulvovaginitis, physiological jaundice, physiological dysbacteriosis, physiological dyspepsia, uric acid infarction, etc. Borderline conditions of newborns are observed by a neonatologist and do not require special treatment.

General information

Borderline conditions of newborns are physiological reactions that reflect the natural adaptation of the newborn organism to extrauterine existence in the neonatal period. In pediatrics, the borderline conditions of newborns are regarded as transient, transient, which last no longer than 3 weeks (in premature babies - 4 weeks) and represent for this age physiological norm. In most cases, the borderline conditions of newborns disappear on their own by the end of the neonatal period, however, if the adaptive capabilities of the child's body are violated, care defects, adverse conditions environment physiological processes can develop into pathological ones that require treatment.

Immediately after birth, the child finds himself in completely different conditions of existence than those that surrounded him throughout the entire period. prenatal development. The baby's body is forced to adapt to a much lower temperature environment; perceive visual, auditory and tactile stimuli; adapt to a new type of breathing, nutrition and excretion, etc., which leads to the development of changes in various body systems, i.e. borderline conditions of newborns.

Consider the main borderline conditions of newborns: their causes, manifestations and pathological processes to which they are predisposed. You can read more about physiological jaundice in newborns.

Newborn Baby Syndrome

This borderline condition of newborns develops under the influence of the release of various hormones in the child's body during childbirth and a large number stimuli (light, sound, temperature, gravity - the so-called "sensory attack"). This causes the first breath, the first cry, the flexion (embryonic) posture of the newborn. In the first minutes after birth, the child behaves actively: he looks for the nipple, takes the breast, but after 5-10 minutes he falls asleep.

Under adverse circumstances, a violation of cardiorespiratory adaptation (cardiorespiratory depression) can develop - depression of vital functions in the first minutes and hours of life.

Physiological weight loss

The real borderline state of newborns is noted in the first days and reaches maximum values ​​by 3-4 days of life - from 3 to 10% of the initial weight in healthy newborns. In full-term children, body weight recovery occurs by 6-10 days (75-80%); in premature babies - by 2-3 weeks of life. The initial loss of body weight is associated with the establishment of lactation in the mother (milk deficiency), excretion of urine and feces, drying of the umbilical cord in the newborn, etc. The key to recovery and good weight gain is early breastfeeding, breastfeeding, feeding "on demand". With a loss of more than 10% of body weight, they speak of malnutrition in a child.

Skin changes

This group of borderline conditions of newborns includes simple erythema, toxic erythema, milia, peeling of the skin.

Simple erythema is understood as diffuse hyperemia of the skin of a newborn, which develops after the removal of the original lubrication due to adaptation of the skin to new environmental factors (air, light, etc.). Severe hyperemia persists for 2-3 days and completely disappears by the end of the 1st week. As the erythema disappears, small-lamellar or large-lamellar peeling of the skin develops, more pronounced on the chest, abdomen, palms and feet in children born from a post-term pregnancy. Treatment of these borderline conditions of newborns is not required; on areas of abundant peeling of the skin after bathing, you can apply sterile vegetable oil or special children's cosmetics.

Approximately one third of newborns on the 2nd-5th day of life develops a borderline condition, regarded as toxic erythema. At the same time, erythematous spots appear on the skin with vesicles containing a clear serous fluid with a large number of eosinophils. The favorite localization of the elements is the skin in the area of ​​the joints, chest, buttocks. Toxic erythema usually regresses after 2-3 days, but may recur within the first month of life. Since toxic erythema is based on an allergic reaction to maternal proteins, with severe manifestations or a protracted course, the pediatrician may prescribe a child to drink plenty of fluids and take antihistamines.

Desquamative vulvovaginitis is a borderline condition of newborn girls, accompanied by the appearance of mucous or spotting from the genital slit. Allocations are noted in 60-70% of girls in the first three days of life and last 1-3 days. In 5-7% of cases, metrorrhagia may develop in a volume not exceeding 1-2 ml, which is associated with the termination of the action of maternal estrogens. Treatment is reduced to holding the toilet of the external genital organs of the girl.

In 5-10% of boys, a hydrocele develops during the neonatal period, which resolves on its own without treatment.

Transient changes in stool

Transitional changes stools in the first week of life occur in almost all newborns. This group of borderline conditions of newborns includes transient intestinal dysbacteriosis and physiological dyspepsia. After passing in the first 1-2 days of meconium (original feces), which looks like a thick viscous mass dark green, the child's stool becomes frequent. Transitional stool has an inhomogeneous texture with an admixture of lumps and mucus, color with alternating areas of dark green and yellow-green. When examining the coprogram, a large number of leukocytes, mucus, fatty acids. By the end of the first week, the stool acquires a homogeneous mushy consistency and a more uniform yellow color. Simultaneously with the cleansing of the intestines, it is populated with bifido- and lactoflora.

The absence of meconium discharge may indicate rectal atresia or intestinal obstruction in the newborn, which requires immediate consultation with a pediatric surgeon. In violation of the formation of the microbial landscape of the intestine, true dysbacteriosis develops.

Changes in kidney function

The borderline conditions of newborns, which characterize the adaptation of the organs of the urinary system to new conditions, include transient oliguria, albuminuria and uric acid infarction of the newborn.

With transient oliguria, characteristic of all healthy newborns in the first 3 days of life, there is a decrease in urine output. The reasons for this phenomenon are the decrease in the intake of fluid into the body and with the peculiarities of hemodynamics.

Marked albuminuria (proteinuria) is caused by an increase in the permeability of the filtration barrier, capillaries and tubules of the kidneys, enhanced hemolysis of erythrocytes.

The pathogenesis of uric acid infarction is associated with the deposition of salts uric acid in the lumen of the renal tubules, which leads to a reddish color of the urine and the appearance of brown-red stains on the diapers. When researching general analysis urine granular and hyaline cylinders, epithelium, leukocytes are found. With uric acid infarction, it is necessary to monitor adequate fluid intake and urine output of the newborn. If this borderline condition in a newborn does not disappear on its own, from about the 10th day of life, changes in urine are regarded as pathological, requiring consultation with a pediatric urologist and ultrasound of the kidneys for a child.

The unfavorable course of these borderline conditions of newborns can serve as the basis for the subsequent development of dysmetabolic nephropathy, urinary tract infections, and urolithiasis.

Other borderline neonatal conditions

Among other borderline conditions of newborns, first of all, one should consider transient disorders of heat metabolism - hypothermia and hyperthermia. Since the birth of a child is marked by a transition to a different environment, the temperature of which is 12-15 ° C lower than in utero, in the first hour of life, a newborn has transient hypothermia (a decrease in body temperature to 35.5-35.8 ° C and below). After a few hours, body temperature rises and stabilizes.

However, the imperfection of thermoregulation, metabolism, overheating on the 3rd-5th day of life lead to an increase in body temperature to 38-39°C, i.e., to the development of transient hyperthermia. At the height of the fever, the child becomes restless, signs of dehydration may develop. Help for a newborn consists in unwrapping the child, prescribing plentiful drink, normalization of environmental conditions (ventilation of the premises).

The borderline conditions of newborns, due to the peculiarities of metabolism, include transient acidosis, hypoglycemia, hypocalcemia, hypomagnesemia. Transient acidosis is associated with changes in acid-base balance and blood gases after birth. Transient hypoglycemia - a decrease in blood glucose concentration to 2.8-3.3 mmol / l is due to the high energy costs of the newborn and the rapid depletion of energy reserves. Hypocalcemia and hypomagnesemia develop as a result of functional hypoparathyroidism occurring in the early neonatal period. These borderline conditions of newborns occur on the first day and disappear by the end of the first week of life.

In addition, borderline conditions in newborns include patent ductus arteriosus and patent foramen ovale, which are described in the relevant reviews.

(physiological weight loss).

It is observed in 100% of newborns. By the 3-4th day of life, the child loses weight, a maximum of 10% of the initial weight at birth is allowed. On average, the weight loss is 4-5%. Recovery occurs by the 7-10th day of life.

Causes:

Malnutrition in the first days of life;

Excretion of water through the skin and lungs;

Loss of water in urine and stool;

Insufficient fluid intake;

regurgitation amniotic fluid;

Drying of the umbilical cord.

Tactics:

Early application to the chest;

Feeding at the request of the child;

Fight against hypogalactia;

Child weight control.

Physiological catarrh of the skin.

(transient erythema of the skin).

It is manifested by simple and toxic erythema.

Simple erythema - reactive redness of the skin (sometimes with a slight bluish tinge of the hands and feet). The reason is the reflex expansion of the skin vessels due to the powerful influence of environmental factors (cold) on the skin receptors of the newborn. In mature full-term newborns, it persists for several hours, less often 1-2 days.

Toxic erythema - is a kind allergic reaction newborn skin. Unlike simple erythema, it does not occur immediately after birth, but on the 2-5th day of life. It manifests itself in the form of hyperemic spots, papules, vesicles on the entire skin, except for the palms and feet. The rash fades after 2-3 days, after which there is a slight peeling.

Tactics:

Thorough skin care;

Hygienic bath with a solution of potassium permanganate.

Transient fever.

It develops as a result of unstable water exchange and imperfection of thermoregulation. Manifested on the 3rd-5th day of life in the form of fever with a temperature of 38-39 degrees C, anxiety, thirst, dry skin and mucous membranes. In 1-2 days the temperature will return to normal.

Causes:

Insufficient amount of fluid intake in the body;

Overheating of the child;

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

Tactics:

Physiological jaundice of newborns.

(transient jaundice).

The appearance of icteric staining of the skin and mucous membranes without disturbing well-being. It appears on the 3rd day, reaches a maximum by the 4th-5th day and disappears by the 12th-14th day of life.

Causes:

Underdevelopment of the enzymatic functions of the liver, in which the death and processing of red blood cells occurs;

Massive destruction of fetal red blood cells (the number of which in the fetus is very large).

As a result of this combination of factors, the erythrocyte pigment that did not have time to be processed accumulates in the skin and mucous membranes, staining them yellow.

Tactics:

Monitoring the child's condition;

Additional drink 5% glucose;

Timely and adequate treatment for a protracted course.

Hormonal (sexual crisis).

It manifests itself as a result of the transition of mother's hormones (estrogens) into the blood of the fetus in the antenatal and intranatal periods and their entry to the newborn with mother's milk.

It may appear as:

1. Physiological mastopathy in boys and girls. At the same time, the child has a symmetrical engorgement of the mammary glands without signs of inflammation. There may be a grayish discharge from the nipples. It appears on the 3rd-4th day, reaches its maximum by the 7th-8th day and disappears by the end of the 2nd-3rd week.
2. swelling of the scrotum in boys, which is also symmetrical and resolves without treatment.
3. Vulvovaginitis in girls. At the same time, discharge from the genital slit of a grayish-white, and sometimes brownish color appears. It manifests itself in the same way as swelling of the scrotum in boys, in the 1st days of life and disappears by the 3rd day.

Tactics:

Careful child care.

Uric acid infarction of the kidneys.

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

Manifested by changes in urine. It becomes cloudy, yellowish-brown in color. After drying such urine on the diapers remain brown spots and sand. It is found on the 3-4th day of life against the background of physiological oliguria (reduced daily urine volume). As the diuresis increases and the crystals are washed out (within 7-10 days), it disappears.

Causes:

Increased breakdown of a large number of cells;

Features of protein metabolism.

Tactics:

Additional drinking of boiled water, 5% glucose.