Early neonatal weight changes, vitamin K, and family-centered care
THE CONTEXT
Early newborn care includes explaining expected weight changes, providing vitamin K, counseling the family, and keeping the healthy newborn with the mother.
Expected weight changes
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Term neonates lose 7–10% of birth weight in the first week and regain birth weight by 7–10 days. Subsequent weight gain is 20–40 g daily.
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Initial weight loss results from loss of extracellular fluid. Later gain reflects increased intracellular water and solids leading to cellular growth.
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Preterm neonates lose more weight, approximately 10–15%, because of immaturity of renal tubular function and skin.
Vitamin K
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Give vitamin K1 to all neonates: 0.5 mg for those weighing less than 1000 g and 1 mg for those weighing more than 1000 g.
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Vitamin K3 can cause hemolysis in G6PD-deficient neonates.
Family communication and rooming in
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At birth, counsel the mother and family about the baby's gender, birth weight, well-being, initiation of breastfeeding within one hour, and need for continued observation.
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A normal newborn should remain with the mother. The neonate is very active during the initial hours, and co-bedding facilitates early breastfeeding and bonding.
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Separation during the initial hours may adversely affect successful breastfeeding.