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Acute water intoxication in healthy infants
Insights
Inappropriate feeding of large volumes of water can cause severe hyponatremia (low sodium) and seizures in infants. Normalizing sodium intake resolves these dangerous metabolic derangements.
Area of Science:
- Pediatric Medicine
- Neonatology
- Clinical Nutrition
Background:
- Infants are vulnerable to fluid and electrolyte imbalances due to immature renal function.
- Inappropriate feeding practices can lead to severe, life-threatening metabolic disturbances.
Observation:
- Two infants presented with profound hyponatremia and seizures after consuming excessive amounts of solute-poor liquids.
- Literature review identified 23 similar cases, all with prior normal renal and neurologic function.
Findings:
- Chronic intake of solute-poor fluids overwhelms the infant's free water excretion capacity.
- This leads to progressive hyponatremia, water intoxication, and subsequent convulsions.
Implications:
- Highlights the critical importance of appropriate fluid and solute management in infant feeding.
- Emphasizes the need for clinician awareness regarding iatrogenic hyponatremia from excessive free water administration.
- Prompt correction of sodium intake is crucial for resolving metabolic abnormalities and preventing long-term sequelae.
Abstract:
We have described two infants with profound hyponatremia and seizures due to metabolic derangements resulting from inappropriate feeding of large volumes of solute-poor liquids. All of the 23 similar cases in the current literature described children with normal renal and neurologic function before and after the episode of hyponatremia. The chronic feeding of solute-poor fluids in these infants impaired their ability to excrete free water, and continued feeding of solute-poor fluids resulted in progressive hyponatremia and convulsions. Upon reinstitution of normal sodium intake, all metabolic abnormalities disappeared.