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Hypernatraemic dehydration and breast feeding: a population study
S Oddie1, S Richmond, M Coulthard
1Neonatal Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP, UK. s.j.oddie@ncl.ac.uk
Insights
Unsuccessful breastfeeding can lead to dehydration with hypernatraemia in newborns, requiring hospital readmission. Early identification and intervention are crucial for managing this potentially serious condition in exclusively breastfed infants.
Area of Science:
- Neonatal care
- Pediatric endocrinology
- Public health
Background:
- Neonatal readmissions represent a significant concern in infant healthcare.
- Dehydration with hypernatraemia is a critical condition that can arise in newborns.
- Exclusively breastfed infants may be at risk if breastfeeding is not established successfully.
Purpose of the Study:
- To estimate the incidence of dehydration with hypernatraemia in exclusively breastfed infants.
- To analyze cases of neonatal readmission for this condition within a defined population.
- To compare findings with existing literature on hypernatraemic dehydration in infants.
Main Methods:
- Population-based regional review of neonatal readmissions.
- Analysis of all hospital readmissions within the first month of life in 1998.
- Case definition for dehydration with hypernatraemia applied to readmitted infants.
Main Results:
- An incidence of at least 2.5 per 10,000 live births was found for dehydration with hypernatraemia in exclusively breastfed infants.
- Eight cases were identified among 907 neonatal readmissions.
- Serum sodium levels ranged from 150 to 175 mmol/l, with one infant experiencing convulsions.
Conclusions:
- Unsuccessful breastfeeding was the sole identified cause of hypernatraemia in these cases.
- The study highlights the importance of monitoring breastfeeding success to prevent severe dehydration.
- Findings underscore the need for timely intervention and support for breastfeeding dyads.
Abstract:
As part of a population based regional review of all neonatal readmissions, the incidence of dehydration with hypernatraemia in exclusively breast fed infants was estimated. All readmissions to hospital in the first month of life during 1998 from a population of 32 015 live births were reviewed. Eight of 907 readmissions met the case definition, giving an incidence of at least 2.5 per 10 000 live births. Serum sodium at readmission varied from 150 to 175 mmol/l. One infant had convulsions. The sole explanation for hypernatraemia was unsuccessful breast feeding in all cases. The eight cases are compared with the 65 cases published in the literature since 1979. Presentation, incidence, risk factors, pathophysiology, treatment, and prevention are discussed.