Newborn Wet and Soiled Diaper Counts and Timing of Onset of Lactation as Indicators of Breastfeeding Inadequacy

Abstract

Using data from 242 exclusively breastfeeding mother-infant pairs, newborn elimination patterns were analyzed. Sensitivity (Se) and Specificity (Sp) of day 4 (72-96 hours) wet and soiled output, in addition to the timing of onset of lactation, in identifying cases of breastfeeding inadequacy (defined as neonatal weight loss >or= 10% of birth weight) were examined. The usefulness of 2 measures in parallel was also explored. Median number of diapers (wet, soiled) on days 1, 4, and 7, respectively, was 2, 3; 5, 4; and 7, 6. The most efficient day 4 predictor of breastfeeding inadequacy was soiled diaper output <or= 3 (Se = .75, Sp = .66). Sensitivity improved when used in parallel with delayed onset of lactation (>or= 72 hours); Se = .86 (95% confidence interval, .73-.99) and Sp = .59 (.55-.63). Fewer than 4 soiled diapers on day 4 when used in conjunction with delayed onset of lactation may be indicative of breastfeeding inadequacy, but low specificity will result in many false positives.

Effect of back Massage on Lactation among Postnatal Mothers

“…Increased lactogenesis in experimental group may be responsible for more frequent urine and stool output. Similar results were in other studies [14].…”

Relationships Among Intrapartum Maternal Fluid Intake, Birth Type, Neonatal Output, and Neonatal Weight Loss During the First 48 Hours After Birth

“…Neonatal output in all feeding groups and birth groups in this study exceeded the minimum expectation set in the literature (Kenner & Lott, 2007;Nommsen-Rivers et al, 2008). The formula fed group recorded more stools and wet diapers overall than either of the breastfed groups.…”

“…The number of wet diapers and stools expected of neonates within the ¢rst few days of life may vary depending on the feeding type. Generally breastfeeding neonates are expected to produce three wet diapers and three stools per day on days 1 and 2 (Nommsen-Rivers, Heinig, Cohen, & Dewey, 2008). If the urinary output is measured, the neonate is expected to produce at least 1 ml/kg/hour (Kenner & Lott, 2007) or 15 to 60 ml/kg/day (Blackburn, 2007).…”

Timing of Stage II Lactogenesis Is Predicted by Antenatal Metabolic Health in a Cohort of Primiparas

“…This is a clinically relevant finding because among exclusively breastfeeding mothers who experience delayed OL, 40% of their infants will lose in excess of 10% of birth weight by day 4 of life. 15,16 There is scant published research examining the relationship between maternal metabolic hormones and early lactation outcomes. Rasmussen and Kjolhede 17 examined absolute and change in concentration between 4 and 7 days postpartum for progesterone, prolactin, insulin (spot sample), glucose, and leptin in 23 normal and 17 overweight/obese women of mixed parity; the only significant finding was a diminished prolactin response in the overweight/obese group.…”