Maternal factors and feeding pattern in neonates admitted with dehydration

Abstract

Background: Some healthy breast-fed infants do not establish an adequate milk intake, continue to lose weight and may develop dehydration. The aim of the study is to find out the maternal factors and feeding pattern of neonates admitted with dehydration.Methods: Hospital based prospective study on neonates (>34 week gestation and >2kg birth weight) with signs/symptoms of dehydration and >10% weight loss after birth admitted in the NICU, MBGH, RNT Medical college, Udaipur, Rajasthan, India for period of 12 months from July 2015-June 2016. Sick neonates with sepsis, birth asphyxia and congenital anomalies were excluded. One apparently healthy neonate and mother selected randomly for each study group dehydrated neonate. Ethical clearance and informed consent for the study was taken.Results: 384 neonates with dehydration were enrolled. Most neonates (96.6%) with dehydration were admitted between Day 3-14 of birth. Dehydration was found in 2.5% caesarean section and 0.8% normal vaginal delivered neonates (p value<0.00001). Dehydrated neonates groups (n=384) was compared with non dehydrated healthy control group (n=384) neonates. Primiparous mothers (p value <0.00001), Pregnancy related complications (p value=0.02), delayed initiation of breast feeding (>1 hour) after birth (p value<0.00001), poor attachment during breast feeding (p value <0.00001), absent let down reflex (p value<0.00001), decreased (<8/day) breast feeding frequency (p value<0.00001), presence of nipple problems (p value<0.001) were more significantly present in dehydrated group as compared to control group. Socioeconomic status, education status and position of mother during breast feeding among mothers in dehydrated group were not significant. 379 neonates were discharged successfully, and 5 neonates expired.Conclusions: Dehydration is a serious problem in breastfed neonates, and early initiation of breast feeding, with proper counselling of breast feeding practices with breast examination in antenatal as well as postnatal period can help in its prevention.