Studying Newborns’ Weight Issues

Weight loss is normal for healthy newborns in the first few days especially for babies exclusively breastfed. While this dip in weight is normal, it can be stressful for parents and family members and in some cases, lead to hyperbilirubinemia and dehydration.

A new study at the University of California, San Francisco called “Healthy Start”  called “Healthy Start” uses EHRs to manage newborn weight loss from the very first day after birth. The Healthy Start program was originally created by the Maternal and Child Health Program within HRSA.

The “Healthy Start” study aims to deliver decision support to healthcare providers caring for newborns to help reassure parents about normal newborn weight loss patterns and helps to decide whether their babies’ weight loss is more than expected.

“We hope the study will improve decision-making concerning whether supplemental feeding or other interventions might be warranted,” said Valerie Flaherman MD, Associate Professor of Pediatrics at UCSF and Lead Author of the study.

Researchers developed the “Newborn Weight Tool (NEWT), a web-based application, to provide clinicians with hour-by-hour newborn weight loss information to identify babies on a trajectory for adverse outcomes.

NEWT was developed by Ian Paul, MD Lead Investigator of Healthy Start at the Penn State Hershey Children’s Hospital and Michael Kuzniewicz, MD, Neonatologist at UCSF Benioff Children’s Hospital, in San Francisco.

The Healthy Start study has simplified the implementation and usage of NEWT by integrating it directly into APeX which is UCSF Health’s EPIC-based EHR system able to automate the data collected by using an external integration platform.

The study enrolls all healthy newborns at UCSF in a randomized, controlled trial. Each EHR record displays the NEWT nomogram automatically with pre-populated weight values, or shows newborn weights in the usual manner, with NEWT being available for access by the clinician outside the EPIC environment.

In the future, the team also hopes to study the effect of their NEWT technology on newborns nationwide in a larger cluster randomized trial conducted in partnership with the “Better Outcomes through Research for Newborns (BORN) Network.

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