Objective We aimed to study the determinants of neonatal weight loss measured on the third day of life in term-infants.
Design The EDEN mother–child cohort is a prospective study that recruited 2002 pregnant women before 24 weeks of gestation in two French university hospitals. Neonates were weighed every day until discharge that occurred on average 4.5 days after birth. Altogether, 1557 healthy term neonates with data on weight at day 3 and feeding mode available were included. The outcome variable was weight loss at day 3 (D3WL), expressed as a percentage of birth weight lost in the first 3 days of life. Our main explanatory variables were maternal pre-pregnancy body mass index (BMI), gestational weight gain, gestational diabetes, birth weight, gestational age and feeding mode.
Results Factors associated with greater D3WL, whatever the feeding mode, were: higher birth weight, gestational diabetes and caesarean section; higher gestational age was associated with a reduced D3WL. The association between maternal pre-pregnancy BMI and D3WL differed by feeding mode (interaction p value=0.0002). In breastfed babies, mean D3WL ranged from 4.9% for neonates of underweight mothers to 5.8% for neonates of obese mothers (p trend=0.0005). In formula-fed babies, D3WL was highest for neonates of underweight mothers (4.1%) and lowest for those of obese mothers (2.6%) (p trend=0.01).
Conclusions The lower D3WL in formula-fed neonates, especially in neonates of obese mothers, suggests a relative overfeeding in the early days compared with breastfed neonates, which may potentially have consequences on later health. Overweight and obese mothers may need extra support to prevent early breastfeeding discontinuation.
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EDEN mother–child cohort study group MA Charles, M de Agostini, A Forhan, B Heude, P Ducimetière (INSERM, U780), M Kaminski, MJ Saurel-Cubizolles, P Dargent, X Fritel, B Larroque, N Lelong, L Marchand, C Nabet (INSERM U953), I Annesi-Maesano (INSERM U707), R Slama (INSERM U823), V Goua, G Magnin, R Hankard, (Poitiers University Hospital), O Thiebaugeorges, M Schweitzer, B Foliguet (Nancy University Hospital), N Job-Spira (ANRS).
Funding We acknowledge all funding sources for the EDEN study: Fondation pour la Recherche Médicale (FRM), French Ministry of Research: IFR program, INSERM Human Nutrition National Research Program, and Diabetes National Research Program (through a collaboration with the French Association for Diabetes Research (ARD)), French Ministry of Health, French Agency for Environment Security (AFFSET), French National Institute for Population Health Surveillance (INVS), Paris–Sud University, French National Institute for Health Education (INPES), Nestlé, Mutuelle Générale de l'Education Nationale (MGEN), French speaking association for the study of diabetes and metabolism (ALFEDIAM), National Agency for Research (ANR non-thematic programme), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 program). Statistical analyses were carried out in complete independence of funders.
Competing interests NR received a grant from Nestlé to subsidize, in part, her PhD.
Patient consent Written consent was obtained from the mother for herself at the beginning of the study and from both parents for the newborn child after delivery.
Ethics approval The EDEN study received approval from the ethics committee (CCPPRB) of Kremlin Bicêtre on 12 December 2002. Files have been declared to the ‘National Committee for Processed Data and Freedom’ (CNIL).
Provenance and peer review Not commissioned; externally peer reviewed.