Neonates typically have a physiological weight loss (PWL) during the first days of life. Several studies about PWL and its influencing factors have been performed worldwide, resulting in the development of normative charts to identify high risk neonates. Up to now there is neither a study about PWL in Latvia nor charts developed for the Baltic region. The objective of the study was to analyse PWL and associated factors in Latvian neonates as well as to evaluate the possibility to use PWL charts of the American Academy of Paediatrics (AAP). The study included data (gestational week, delivery type, sex, feeding type, health status) of 220 Latvian newborns treated in the neonatology department of Children Clinical Hospital Gaiļezers and in-an out-patient praxis in Riga. Their mean PWL was compared among neonates with different factors and plotted on PWL charts. The mean PWL was 6.4% (SD ± 2.31%) and in univariate analysis it was associated with feeding type (p = 0.06) and health status (p = 0.01). In multiple regression analysis PWL was significantly associated with health status (p = 0.01). The usage of AAP charts could be generally recommended to identify high risk neonates, but development of charts for the Baltics should be discussed..