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Reference chart for relative weight change to detect hypernatraemic dehydration

Paula van Dommelen1, Jacobus P van Wouwe, Jacqueline M Breuning-Boers

  • 1TNO Quality of Life, Leiden, The Netherlands. P.vanDommelen@pg.tno.nl

Archives of Disease in Childhood
|August 2, 2006
PubMed

Insights

The common 10% infant weight loss rule may yield too many false positives for detecting hypernatraemic dehydration. A relative weight change chart offers a more specific screening tool for breastfed infants.

Area of Science:

  • Pediatrics
  • Neonatal Care
  • Clinical Nutrition

Background:

  • The widely used 10% infant weight loss rule's accuracy for detecting hypernatraemic dehydration is unverified.
  • Hypernatraemic dehydration is a serious condition in breastfed infants requiring accurate early detection.

Purpose of the Study:

  • To evaluate the validity of the 10% weight loss rule and other methods for identifying breastfed infants with hypernatraemic dehydration.
  • To develop and assess a more reliable screening tool for this condition.

Main Methods:

  • A retrospective cohort study constructed a reference chart for relative weight change in healthy, exclusively breastfed infants using the LMS method.
  • Data from 1544 infants (3075 measurements) and 83 literature cases of hypernatraemic dehydration were analyzed.

Main Results:

  • The 10% rule showed 90.4% sensitivity but only 3.7% positive predictive value.
  • A chart-based method (<-2.5 SDS in the first week) combined with the 10% rule in the second week improved specificity to 99.4% with a 9.2% positive predictive value.

Conclusions:

  • The 10% weight loss rule is prone to false positives, making it less suitable for high-specificity screening.
  • A relative weight change chart is a more effective tool for detecting hypernatraemic dehydration in breastfed infants.
Abstract

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