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Oral water intoxication in infants. An American epidemic
J P Keating1, G J Schears, P R Dodge
1Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St Louis, Mo.
Insights
Water intoxication in infants is rising, often due to formula shortage leading to excessive water intake. Treatment involves saline infusions, and prevention requires improved infant formula access and maternal education on water ingestion risks.
Area of Science:
- Pediatrics
- Public Health
- Toxicology
Background:
- Water intoxication, previously rare, shows a marked increase in incidence.
- Thirty-four cases were treated between 1975 and 1990, with a significant rise in the last three years.
- Thirty-one patients were infants from low-income households, ingesting excessive water due to formula unavailability.
Purpose of the Study:
- To analyze the incidence and causes of water intoxication in infants.
- To evaluate treatment methods and outcomes for water intoxication.
- To propose preventive strategies for this condition.
Main Methods:
- Retrospective analysis of 34 pediatric cases of water intoxication treated between 1975 and 1990.
- Review of patient demographics, socioeconomic factors, and reasons for excessive water intake.
- Assessment of treatment protocols, including hypertonic and isotonic saline infusions, and observed complications.
Main Results:
- A significant increase in water intoxication cases was observed, particularly in infants.
- The primary cause identified was the substitution of infant formula with excessive water, often due to poverty and formula shortages.
- Treatment with hypertonic or isotonic saline was effective, with no observed cases of central pontine myelinolysis.
Conclusions:
- Water intoxication in infants is a preventable condition linked to socioeconomic factors and inadequate formula supply.
- Educational interventions for mothers regarding the dangers of excessive water consumption are crucial.
- Policy modifications, such as enhancing the Special Supplemental Food Program for Women, Infants, and Children (WIC), could mitigate this public health issue.
Abstract:
Between 1975 and 1990, a total of 34 patients with water intoxication were treated at St Louis (Mo) Children's Hospital, 24 of these in the last 3 years, indicating a marked increase in incidence of this previously rare condition. Thirty-one were infants living in poverty who ingested excessive amounts of water offered at home by their caretakers. Exhaustion of the supply of infant formula was the most common reason given for this substitution. Infants were treated by a single infusion of hypertonic saline or a slow infusion of isotonic saline. Central pontine myelinolysis was not observed as a complication of hypertonic saline therapy. Modification of the Special Supplemental Food Program for Women, Infants, and Children to provide sufficient formula for the growing infant and better education of mothers as to the hazards of excessive water ingestion might reduce the incidence of this preventable and life-threatening condition.