Physiological weight loss chart helps to identify high-risk infants who need breastfeeding support.

AIM: Healthy, full-term, exclusively breastfed infants are expected to lose weight in the first days after birth, but experts disagree about what constitutes a physiological neonatal weight loss and there is a lack of evidence-based data. Our study aimed to construct a centile chart of neonatal weight loss in a healthy population of exclusively breastfed term neonates. METHODS: We retrospectively studied all infants born at an Italian centre that focused on natural childbirth from April 2007 to December 2012 and who complied with World Health Organization guidance on infant feeding. The infants' weight loss was recorded after 12, 24, 36, 48, 60 and 72 h of life. RESULTS: We included 1760 healthy, full-term, singleton babies born by vaginal delivery. Their mean weight loss was 5.95 ± 1.73%, 72.2% had maximal weight loss before discharge, only 3.9% lost more than 9% of their birthweight, and no infant lost more than 10%. We measured the percentage weight change from birth and each time the infant was examined, summarising how their weight varied in the first 72 h of life. CONCLUSION: Our normative chart of physiological weight loss provided an important instrument for identifying high-risk infants who required breastfeeding support.

Behavior of the Newborn during Skin-to-Skin.

BACKGROUND: Early skin-to-skin contact (SSC) significantly increases the breastfeeding rate in healthy term infants. OBJECTIVE: This study aimed to confirm previously described behavioral sequences during SSC. METHODS: We recorded live and videotaped infant behavioral sequences during SSC in a cohort of healthy term infants, whose outcome was then evaluated. RESULTS: We studied 17 mother-infants dyads. While the majority of infants (59%) had behavioral phases that have been previously reported, some of them had alternative sequences. We observed the infant's massage of the mother's breast with its hand during SSC, which had not been previously reported. We found no correlations between behavioral sequence during SSC, breastfeeding, and neonatal outcome. Moreover, maternal pain stimuli did not affect the neonatal SSC behavioral sequence. CONCLUSION: Our study confirms that immediate and undisturbed postpartum SSC is characterized by specific behavioral phases whose sequence may vary without affecting the suckling rate at the end of SSC, breastfeeding success, or the short-term neonatal outcome.

Metabolomic profile of term infants of gestational diabetic mothers.

OBJECTIVE: Maternal diabetes increases the risk of perinatal mortality and morbidity, but the maintenance of antenatal normal glucose serum prevents the majority of neonatal complications. The aim of our study is to compare the metabolomic profile of infants of gestational diabetic mothers (IGDMs) to that of infants of healthy mothers to evaluate if differences remain despite a strict control of gestational diabetes. METHODS: We performed the metabolomics study in cord serum sampled from 30 term IGDMs and 40 controls recording the occurrence of the most frequent complications in IGDMs. RESULTS: We demonstrated that IGDMs have lower level of glucose and higher level of pyruvate, histidine, alanine, valine, methionine, arginine, lysine, hypoxanthine, lipoprotein and lipid than controls, but we did not find any clinical differences. CONCLUSIONS: Our results suggest that prolonged fetal exposure to hyperglycemia during pregnancy can change neonatal metabolomic profile at birth without affecting the clinical course.