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Physiological weight loss – breastfed — RACP Paediatrics MCQ

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EasyNeonatalPhysiological weight loss – breastfedRACP Paediatrics

A 3-day-old breastfed neonate has lost 6% of birth weight. He is feeding actively 8-10 times per day, has 3 wet nappies per day, and is passing meconium transitioning to yellow stools. Examination is normal. What is the most likely assessment?

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Correct answer: A — Normal – physiological weight loss

Weight loss up to 7-10% in the first 3-5 days is physiological in breastfed neonates (reflecting extracellular fluid loss and limited initial milk intake). Birth weight should be regained by 10-14 days. This infant has appropriate feeding frequency, adequate output, and a weight loss within physiological range. Reassurance and continued breastfeeding support are appropriate.

Reference: RCH Melbourne – 2023 – Breastfeeding CPG; RACP Paediatric Curriculum – Neonatology