What is the maximum physiologic weight loss considered normal for very premature neonates in the first days of life?

• A. 5%
• B. 10%
• C. 15%
• D. 20%

Answer: (C)

Physiologic weight loss in very premature neonates in the first days is driven by fluid shifts, immature kidney function, and limited initial intake. A loss of up to about 15% of birth weight is considered normal in this group. This early drop typically occurs in the first several days, with most infants beginning to regain weight as feeds are established, usually by about day 7–10. If weight loss approaches or exceeds 15% or there are signs of inadequate intake, decreased urine output, or clinical dehydration, assess and optimize nutrition and fluids (including fortification or parenteral support as needed) and look for other causes of illness.