[Neonatal dehydration (dehydration fever) in newborn infants].
BACKGROUND
The aim was to identify characteristics in infants suffering from dehydration caused by breast-feeding malnutrition over a period of 21 months in South Denmark.


METHODS
Infants admitted to a regional Paediatric Clinical Department in a rural area with a population of 254,000 and approximately 3000 live births per year. The infants were admitted with the diagnosis of dehydration fever, jaundice and dehydration, hypernatraemic dehydration or malnutrition. The cases were reviewed retrospectively and the outcome measures were maternal age and parity, the gestational age of the infant, birth weight, per cent loss from birth weight, complaints at presentation, age on admission, temperature on admission, and levels of blood glucose and serum sodium.


RESULTS
Fifty-four newborn infants were identified. Thirty-five infants had a temperature between 37.6 and 39.7 degrees C on admission. Thirty-seven infants had lost between 8% and 23.3% of their birthweight. Twenty infants suffered from hypernatraemic dehydration, their serum-sodium levels were 147-159 mmol/l. Four infants with hypernatraemic dehydration had lost less than 8% of the birth weight. Ten infants were large for gestational age (LGA). Compared to a control group, there was an overrepresentation of LGA children in the study group (p = 0.003). Thirty-one of 50 mothers were primigravida (p = 0.002). Thirty-one of 54 mothers were 30 years old or older (p = 0.05). There was a positive correlation between weight loss and high serum sodium levels (p = 0.01).


CONCLUSIONS
We found that a rise in temperature can be a sign of neonatal dehydration and malnutrition in breast-fed infants. Hypernatraemic dehydration can occur even if the weight loss is less than 10% of the birth weight. Infants who are LGA can also develop neonatal dehydration.
Zachariassen
Gitte
G
Sønderborg Sygehus, børneafdelingen, Odense Universitetshospital, børneafdelingen. gittez@dadlnet.dk
Juvonen
Pekka
P
D000328:Adult; D001724:Birth Weight; D001942:Breast Feeding; D003681:Dehydration / Q000209:etiology*; D005260:Female; D005334:Fever / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D006955:Hypernatremia / Q000150:complications; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000150:complications; D008423:Maternal Age; D012189:Retrospective Studies; D015431:Weight Loss