First-Day Use of the Newborn Weight Loss Tool to Predict Excess Weight Loss in Breastfeeding Newborns.
First-Day Use of the Newborn Weight Loss Tool to Predict Excess Weight Loss in Breastfeeding Newborns.
复制标题
第一天使用新生儿减肥工具来预测母乳喂养新生儿的过度体重减轻。
DOI：
10.1089/bfm.2020.0280
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Nommsen-Rivers,LaurieA
中科院分区：
文献类型：
--
作者：
Smith,AnnaP;Ward,LauraP;Heinig,MeredithJane;Dewey,KathrynG;Nommsen-Rivers,LaurieA
背景和目标：建议大多数新生儿进行纯母乳喂养。然而，纯母乳喂养的新生儿有时会在哺乳期间出现体重过度减轻（EWL，体重减轻≥出生体重的 10%）。我们的主要目标是评估新生儿减肥工具 (NEWT) 在早期识别发生 EWL 的纯母乳喂养新生儿中的敏感性和特异性；其次，确定与高危NEWT轨迹相关的母乳喂养变量。 材料和方法：我们对母婴二人组的前瞻性数据进行了二次分析，这些母婴二人组筛选纳入世界卫生组织生长参考研究美国网站。如果出现以下情况，我们会排除记录：不满足 NEWT 特定标准、缺少关键数据或消耗的配方奶粉超过 60 毫升。我们根据大约 24 小时的院内体重落在与最终 EWL 一致的 NEWT 轨迹内，将 NEWT 定义为“测试阳性”。我们根据出生后第 4 天在家测量的体重 (DoL4) 将病例定义为真正的 EWL。结果：在 280 份原始记录中，排除了 60 份（n= 27，NEWT 特定排除；n= 15，缺失数据；n= 18，>60 mL 配方奶），从而产生了 220 对在医院测量的配对新生儿体重（17±8 小时），和 DoL4（84±8 小时）。 NEWT 状态正确识别了 6/28 个 EWL 病例（21% 敏感性 [95% 置信区间，CI，8–34%]）和 158/192 个非病例（82% 特异性 [95% CI，75–89%]）。 NEWT 测试阳性状态与更大的体重减轻、较低的母乳喂养支持感知以及婴儿较少在 DoL4 上显示喂养提示相关 (p< 0.05)。 结论：在出生后 24 小时左右应用 NEWT 时，预测 EWL 的敏感性较低；然而，早期检测呈阳性状态与 DoL4 母乳喂养困难的指标相关。
Background and Objectives:Exclusive breastfeeding is recommended for most newborns. However, exclusively breastfed newborns sometimes experience excess weight loss (EWL, loss ≥10% of birth weight) while lactation is being established. Our primary objective was to evaluate the sensitivity and specificity of the Newborn Weight Loss Tool (NEWT) in early identification of exclusively breastfed newborns who develop EWL; and secondarily, identify breastfeeding variables associated with an at-risk NEWT trajectory.Materials and Methods:We conducted a secondary analysis of prospective data from mother–infant dyads screened for inclusion in the U.S. site of the WHO Growth Reference Study. We excluded records if: NEWT-specific criteria not met, missing key data, or >60 mL formula consumed. We defined NEWT “test-positive” based on an in-hospital weight at about 24 hours falling within the NEWT trajectory consistent with eventual EWL. We defined cases as true EWL based on weight measured at home on day of life 4 (DoL4).Results:Of 280 original records, 60 were excluded (n= 27, NEWT-specific exclusion;n= 15, missing data;n= 18, >60 mL formula), resulting in 220 paired newborn weights measured in-hospital (17 ± 8 hours), and at DoL4 (84 ± 8 hours). NEWT status correctly identified 6/28 EWL cases (21% sensitivity [95% confidence interval, CI, 8–34%]), and 158/192 noncases (82% specificity [95% CI, 75–89%]). NEWT test-positive status was associated with greater weight loss, lower perceived breastfeeding support, and infant less often showing feeding cues on DoL4 (p< 0.05).Conclusion:Sensitivity in predicting EWL is low when applying NEWT at about 24 hours of life; however, early test-positive status is associated with indicators of breastfeeding difficulties on DoL4.