Each year four million neonates die, the majority in the first week of life . Most deaths occur in the developing world and are due to neonatal sepsis, birth complications and prematurity [1, 2]. To have any hope of achieving the 4th Millennium development goal (a two third reduction of deaths in children less than five years of age), a decrease in the number of neonatal deaths must occur . Assessing a neonate for signs of illness is often subjective. An unwell neonate can have subtle signs which can be missed, even by trained health care workers. Infants with neonatal sepsis can present in a number of ways: respiratory distress, temperature instability, cyanosis, hypotension, lethargy, hyperbilirubinaemia, abdominal distension, prostration, weak or absent movement, abnormally irritable or sleepy, abnormal feeding, inability to console infant, or with a bulging fontanelle [3–5]. Therefore, an objective measurement of neonatal wellbeing would be an invaluable tool, especially in resource poor settings where other diagnostic capacities are limited.
It is well established that infants will lose weight in the first few days of life . Studies performed in developed countries quote a weight loss of between 4 – 7% in the first days of life [7, 8]. However, there is a paucity of data regarding weight loss in normal infants in developing countries.
Calculating weight loss or weight gain is useful in the evaluation of a neonate. For example a weight loss of greater than 10% has been associated with dehydration and hypernatremia . As part of an initial assessment, calculating whether the infant has lost more weight than would be expected for their age can guide management by objectively demonstrating at risk infants (for example infants who have lost too much weight from insufficient feeding or increases loses from diarrhoea). Calculating weight gain and comparing to expected values can aid evaluation of an infant’s recovery. For these useful calculations to be made, the expected weight loss and weight gain must be known.
In conventional paediatric practice weight loss in the first seven days of life is described as a percentage loss from birth weight and weight gain as a growth velocity (g/kg/day) .
The aim of this analysis was to describe the normal weight change in a breast fed infant in the first seven days of life and to evaluate whether this change was the same for normal weight infants, low birth weight infants (< 2.50 kg) and small for gestational age infants.