Neonates have high nutrient demands. Exclusive breastfeeding, an effective way to ensure child health and survival, is recommended for neonates within the first hour of birth and to be continued on demand for the first 6 months of life. However, exclusively breastfed neonates typically lose about 7% of their birth weight prior to beginning weight gain. Risk factors for inadequate neonatal growth may include low birth weight and weight loss greater than 5% at 4 days of age.1,2 Different phenotypes of low birth weight such as preterm birth and intrauterine growth restriction may differ in nutrition requirements and response. While initial weight loss is often transient and may not have subsequent consequences in the majority of healthy term neonates, it may have serious consequences for more vulnerable, at-risk neonates, including those with low birth weight or who were born preterm, particularly in resource-constrained settings in Africa and Asia.