Categorizing weight loss in breastfed infants: a good first step.

One of the most gratifying public health trends over the past 50 years in the United States has been the increasing rate of breastfeeding among newborn infants. In 1965, it was estimated that <30% of neonates born in the United States were breastfed; by 2011, the percentage of infants who were at least partially breastfed had risen to 79%.1,2 A major focus of contemporary care during the birth hospitalization is the management of breastfed infants. Although much effort is centered on the provision of optimal instruction and support to mothers initiating breastfeeding, an equally important goal is to appropriately diagnose and manage newborns with breastfeeding difficulties. The results of the study by Flaherman et al in this issue of Pediatrics provide much needed data for both of these efforts.3 Using a large database and an elegant methodology, Dr Flaherman and her colleagues have constructed nomograms that describe weight loss in breastfed infants during the first few days of life. With the nomograms, clinicians can plot the percent weight loss for a neonate at a specific age and determine, with precision, whether this percentage is normal for a … Address correspondence to James A. Taylor, MD, University of Washington, Box 354920, Seattle, WA 98195. E-mail: uncjat{at}uw.edu