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Hypernatraemic dehydration and acute gastro-enteritis in children
1Department of Paediatrics, Jordan University of Science and Technology, Irbid, Jordan. faisall52@yahoo.com
Insights
Artificial milk, especially evaporated cow's milk powder, significantly increases hypernatraemic dehydration risk in infants with gastroenteritis. Breastfeeding is protective, highlighting the need for maternal education on safe infant feeding practices.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Hypernatraemic dehydration is a serious complication in infants with acute gastroenteritis.
- Artificial milk formulae, particularly evaporated cow's milk, are suspected contributors.
- Understanding feeding practices is crucial for preventing severe outcomes.
Purpose of the Study:
- To investigate the role of artificial milk formulae in hypernatraemic dehydration among infants with gastroenteritis.
- To compare feeding practices between hypernatraemic and isonatraemic dehydration groups.
- To record morbidity and mortality associated with hypernatraemic dehydration.
Main Methods:
- Prospective study over 2 years.
- Inclusion of 67 infants (18 days-18 months) with hypernatraemic dehydration (serum sodium ≥ 150 mmol/L).
- Comparison with a control group of infants with gastroenteritis and normal sodium levels.
Main Results:
- 36% of hypernatraemic infants were fed evaporated cow's milk powder, versus 15% in controls (p < 0.01).
- Only 7.5% of hypernatraemic infants were breastfed, compared to 60% of controls (p < 0.00001).
- Convulsions occurred in 6 hypernatraemic children, and 2 died.
Conclusions:
- Artificial milk feeding, especially evaporated cow's milk, is a significant predisposing factor for hypernatraemia in infantile gastroenteritis.
- Breastfeeding is strongly associated with protection against hypernatraemic dehydration.
- Maternal education on avoiding evaporated cow's milk formulae for infants under one year is essential.
Abstract:
A prospective study was conducted over a 2-year period to detect the effect of feeding practice, in particular the role of artificial milk formulae, in children admitted with hypernatraemic dehydration (serum sodium > or = 150 mmol/L) caused by acute gastro-enteritis, and to record morbidity and mortality in these patients. A control group was selected from infants and children admitted with gastro-enteritis but normal sodium levels. Sixty-seven children aged 18 days to 18 months (mean 6.9 months) were studied and represented 4.6% of all children admitted during the study with acute gastro-enteritis. Their mean serum sodium level was 161 mmol/L, the highest being 194 mmol/L. Twenty-four infants (36%) with hypernatraemic dehydration were on evaporated cow's milk powder compared with ten (15%) in the control group (p < 0.01). Five hypernatraemic infants (7.5%) were breastfed compared with 40 (60%) isonatraemic controls (p < 0.00001). Six children from the hypernatraemic group developed convulsions and two died. Hypernatraemic dehydration remains an important and serious complication in infants with gastro-enteritis in our area. Artificial milk feeding, particularly the use of evaporated cow's milk powder, is a predisposing factor for hypernatraemia in infantile gastro-enteritis. This study emphasises the importance of breast-feeding and the need to educate mothers to avoid giving evaporated cow's milk formulae to babies under 1 year of age if breast-feeding is not possible.