Neonatal Hypernatremic Dehydration Research Articles

PP-327. Evaluation of breast milk sodium and neonatal hypernatremic dehydration

PP-327. Evaluation of breast milk sodium and neonatal hypernatremic dehydration

Breastfeeding-associated Neonatal Hypernatremic Dehydration in a Medical Center: A Clinical Investigation

Hypernatremic dehydration amongst exclusively breastfed neonates due to inadequate breastfeeding or underfeeding is a potentially devastating condition. We investigated the epidemiological and clinic features of hypernatremic dehydration. We retrospectively reviewed the medical records of neonates that were less than 28 days of age, weighing > or =2000 g with gestational age of 36 weeks born between January 2002 and December 2005, who had meet the criteria of hypernatremic dehydration, including (1) exclusively breastfed; (2) loss of weight 12% or more from birth weight; and (3) serum sodium concentration of at least 150 mmol/L at presentation, that had been subsequently admitted to our institution. Totally nine cases were found during this four-year period, an incidence of 2.3 per 1000 live births. Involved infants' age at presentation ranged from 3 days to 14 days (mean t Standard Deviation = 7 +/- [3.8]); five presented symptoms or signs within the first week of life. Study-involved infants featured a birth-weight loss ranging from 12% to 29% (mean +/- [SD] = 17.0 +/- [5.9]), and also hypernatremia (mean +/- [SD] = 153.5 +/- [3.2] mEq/L ). Sodium concentration of breast milk ranged from 15 mEq/L to 54 mEq/L (mean +/- [SD]= 36.0 +/- [14.32]). Subsequently, all were supplemented with breast milk or, alternatively, formula. None of the study-involved neonates suffered subsequent complications or a relapse of their condition. Neonatal hypernatremic dehydration due to inadequate breastfeeding or underfeeding would appear to be a rather common problem. In order to avoid serious morbidity and mortality, all breastfed infants should receive regular follow-up by health-care worker. Furthermore, we advocate that all mothers should be taught the skills of breastfeeding, and warning signs of breastfeeding failure and hypernatremia, accompanied with the monitoring of the weight of infants until growth commences, in order to reduce the likelihood of this condition arising, especially for first-time mothers.

CRANIAL MR VENOGRAPHY FINDINGS OF SEVERE HYPERNATREMIC DEHYDRATION IN ASSOCIATION WITH CEREBRAL VENOUS THROMBOSIS IN THE NEONATAL PERIOD

Severe neonatal hypernatremia is an important electrolyte disorder that has serious effects on the central nervous system, including brain edema, intracranial hemorrhage, hemorrhagic infarct, and thrombosis. Cerebral venous thrombosis is relatively rare in severe neonatal hypernatremic dehydration. The English literature contains only a few reports of the cranial radiological findings in severe neonatal hypernatremia. The authors report cranial MR venography findings of a newborn infant with severe hypernatremic dehydration. To the best of their knowledge, this is the first such report in the English literature.

Déshydratation hypernatrémique et allaitement maternel

Neonatal hypernatremic dehydration due to breast feeding was rarely reported in the French-language literature. Case report. – The authors report hypernatremic dehydration in a 10-day-old exclusively breast-fed infant. The course was favorable. Insufficient breast milk production has been reported for 30 years. Conclusion. – Early discharge from maternity units is frequent nowadays. Breast-fed newborns without a positive weight gain at discharge should be checked for their weight within the first ten days of life.

Neonatal hypernatremic dehydration due to excessively concentrated prepared milk formula.

Excessively concentrated milk formula was administered accidentally to five newborn infants. Diarrhea, dehydration, hypernatremia, and hyperosmolality were present in all of them. Abnormal neurologic manifestations during the acute disease were observed in one infant. On follow-up, psychomotor development and electroencephalographic recordings were normal in four infants. One infant, in whom accelerated growth of head circumference had been noted before the episode of diarrhea, was found to have obstruction of the foramen of Monro at the age of 6 weeks. Possible errors in preparing milk formulas by medical staffing resulting in hypertonic dehydration are stressed in this report.