Is Infant weight loss after birth normal?

Dear Doctor,

I recently had a baby who weighed 3.6kgs. When I took him for his two-week clinic visit, he had lost a few grammes and weighed 3.2kgs. The nurse told me not to worry but it left me wondering if maybe, he is not getting enough milk. Henrietta

Dear Henrietta,

I have come across enough cases where moms come to me worried or even depressed that their newborns have lost weight, especially when they weigh their babies within two to three weeks after delivery.

Most are usually worried that the birth weight has dropped instead of increasing. This is a fairly usual occurrence for newborns, so moms give it a rest.

According to a recent study published on ‘Paediatrics Journal’, exclusively breastfed newborns typically lost as much as ten per cent or more of their birth weight before beginning to gain again in the first days after birth.

By 48 hours, almost 5 per cent of babies born normally and ten per cent of those born by caesarean delivery lost at least ten per cent of their birth weight. By 72 hours, 25 per cent of caesarean delivered infants lost at least ten per cent of their birth weight.

According to Valerie J Flaherman, one of the authors from the School of Medicine at the University of California, San Francisco, “These results provide the first graphical depiction of hourly weight loss for exclusively breastfed newborns from a large, diverse population, because weight changes steadily throughout the birth hospitalization and is measured at varied intervals from the hour of birth.”

Usually, a weight loss consisting of anything under ten per cent of a baby’s birth weight is considered normal and not a concern. Babies have extra fluid when they are born, and in the days after birth, they lose this fluid.

They don’t need to eat much yet, so they are not replacing this fluid loss for a few days. After the mother’s milk comes in and the baby starts eating more, the lost weight will be regained.

This weight loss usually starts in newborns before they leave the hospital and can last for two or three days. Once the baby starts nursing regularly, the weight will start to rise again. Within ten days to two weeks, the baby should have regained its birth weight.

 Typical weight gain during the first few months is 150 - 200 grammes per week. Look out for signs of illness that may suggest that your baby is losing too much weight. These include: persistent crying or irritability, lethargy or listlessness, loose stools, vomiting, poor feeding and fever.