Showing posts with label weight. Show all posts
Showing posts with label weight. Show all posts

Wednesday, December 3, 2014

Early Weight Loss Nomograms for Exclusively Breastfed Babies Have Arrived!

By: Lewis First, MD, MS; Editor-in-Chief 

newborn infant
Newborn infant. Photo by singingbeagle via Flickr.
For years, if not decades, we have simply told mothers of breastfed babies to expect their infants to lose about 10 percent of their weight during their first week of life as mom’s breast milk comes in. Yet how reliable and valid is that comment?

Flaherman et al. (doi: 10.1542/peds.2014-1532) attempted to look at the question of what is normal and abnormal early weight loss by gathering weights over time for over 161,000 infants who were over 36 weeks gestational age and exclusively breastfed.

The authors discovered differential weight loss by mode of delivery (vaginal versus caesarean) within hours of delivery and created nomograms to show birthweight loss over time and percentiles for those curves so as to identify neonates falling off curves, showing greater weight loss, and in turn signaling perhaps other morbidities preventing the good beginning infants need to get out of the starting gate.

These nomograms, as contained in this article and further discussed in an interesting accompanying commentary by Drs. James Taylor and Elizabeth Simpson (doi: 10.1542/peds.2014-3354), should be posted in your local nursery and used frequently in determining just how much you and the mother of your newest patients need to worry or  intervene to insure adequate breastfeeding and in turn weight gain occurs in the early days of a baby’s life.

Chart a course for this study and learn more about these new nomograms.

Related Reading:

Tuesday, December 2, 2014

Two Breastfeeding Studies Provide New Information Worth Sharing with Parents

By: Lewis First, MD, MS; Editor-in-Chief 

Breastfeeding icon.
Public domain via Wikimedia Commons
There are many evidence-based reasons to exclusively breastfeed newborns and infants. Yet despite the evidence, mothers opt to not exclusively breastfeed for the recommended one-year duration, let alone six months or even a shorter time period. Yet each addition to the body of breastfeeding literature hopefully further convinces an expectant mother or one that has just given birth to choose exclusive breastfeeding as the best way to ensure the growth and development of her newborn.

Thus this week, we provide two additional studies that we found well worth sharing in our journal.

The first, by Abbass-Dick et al. (doi: 10.1542/peds.2014-1416), involved a randomized controlled trial to see if co-parenting breastfeeding support resulted in increases in breastfeeding duration and mothers feeling more supported by paternal partners.

The study involved more than 100 couples randomized to get either usual care or an intervention involving both parents’ involvement in understanding and supporting breastfeeding. The results of the co-parenting intervention are most impressive and may further enhance a mothers desire to continue to exclusively breastfeed for as long as she can.

The second study by Carling et al. (doi: 10.1542/peds.2014-1392) was a prospective observational study of mothers in rural and central New York of weight gain trajectories for the first two years of life in almost 600 infants.

The authors controlled for a number of possible confounders and found that the trajectories most worrisome for obesity risk were associated with the shortest duration of breastfeeding—especially if an infant breastfed for less than two months.

Since other studies have demonstrated that an overweight or obese younger child means increased risk of obesity up the road, this study should weigh heavily in your discussion with families of the importance of breastfeeding –especially if that family has a history of being overweight or obese.

Check out both studies—and then share what you learned with families of your infant patients. If they were on the fence about breastfeeding, these two studies may tip the balance in support of this important method of feeding.

Related Reading:

Monday, August 25, 2014

Parental Perceptions of Overweight 20 Years Ago and Today: The Times (and BMIs) They Are a Changin’!

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by epSos.de via Flickr
Part of the problem of trying to get a family to help their overweight child lose weight is getting parental buy-in—and that begins when parents agree that their child is medically perceived to be overweight. One would think that parents would view their child as being overweight quite easily—and while that may have been true 20 years ago—it is not as easily perceived today—at least according to a study we are sharing this week by Hansen et al. (doi: 10.1542/peds.2014-0012).

The authors looked at survey data from parents on close to 3,000 children (ages 6-11 years) enrolled in the National Health and Nutrition Examination Survey in 1988 through 1994 and another cohort enrolled in 2005 to 2010 and found some substantive differences. Parents today are less likely to perceive their child as overweight: They did not view weight gain above the 85th percentile but below the 91st percentile as concerning, whereas 20 years ago it was.

What does this shift in social norms mean for the health of children who are showing increased body weight and crossing high percentiles on a growth curve? Weigh in on the information contained in this study and then perhaps share it with parents of overweight patients and see if it can’t help them realize that their child’s increasing BMI over time really is a problem.

Related Reading: