Date of Award

2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Debra Erickson Owens

Abstract

Growing evidence suggests that infants may experience increased weight loss due to maternal medical interventions during labor such as intravenous fluid hydration. When breast fed infants lose ≥ 7% of their birth weight, formula supplementation is often initiated. Formula supplementation is a variable unequivocally associated with shorter breastfeeding duration. Supplementation should not be initiated if the cause of infant weight loss is unrelated to breastfeeding adequacy. The purpose of this study is to examine the impact of intrapartum maternal hydration and regional anesthesia on infant weight.

A retrospective, case-control research study was designed. Data was collected from maternal and infant hospital records. A sample of 272 women and their full-term breastfeeding infants delivered by cesarean section were assigned to either a case (≥ 8% loss) or control (< 8% loss) group depending on the infant’s weight on day three of life. Exclusion criteria included significant maternal or infant illness. Analysis revealed that the mean weight loss for all infants was 7.34% and that 54% of the infants lost ≥ 8%. Maternal demographic variables were similar between groups. More mothers in the case group had private insurance (p = .03) and less mothers underwent induction of labor (p = .01). Infants in the case group had heavier birth weights (p = .001). On day four, the exclusive breastfeeding rate had dropped to 53% in the case group compared to 80% in the control group. In the case group infant stools were significantly lower on days two to four and there was a trend toward more voids on day one (p = .09). Maternal IV fluid volume and type of anesthesia were not significantly different between groups. Only 69 (25%) of the women received ≥ 3000 ml of IV fluid. An exploratory analysis of 20 infants whose mothers received ≥ 4000 ml showed that 14 (70%) did experience weight loss ≥ 8%.

Epidural anesthesia does not appear to impact infant weight compared to spinal anesthesia. The effects of IV fluid on infant weight remain undetermined. Studies need to examine the impact of maternal IV fluid ≥ 3000 ml on infant weight.

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