title: Hypernatraemic dehydration in Jamaican breastfed neonates: a 12-year review in a baby-friendly hospital.
abstract: A 12-year retrospective review of neonates admitted with hypernatraemic dehydration to the neonatal unit of the University Hospital of the West Indies was conducted between 1 January 1990 and 31 December 2001. Twenty-four infants fulfilled the criteria for hypernatraemic dehydration. Nineteen (79%) women were either nulliparous or primiparous with a mean (SD) age of 26.9 (4.4) yrs. Modal length of hospital stay for mothers was 24 hrs. Twenty (83.3%) infants were exclusively breastfed. Mean (SD) age at presentation was 7.4 (3.8) days. Mean (SD) percentage weight loss between birth and presentation was 18.9% (6.3). Mean (SD) serum sodium at presentation was 164.8 (13.9) mmol/L. Babies visited at home by nurses had a lower mean serum sodium, were less dehydrated and were significantly less acidiotic. Their mean (SD) length of hospital stay was also significantly less [4.2 (1.4) days] than those who were not visited [7.9 (3.8) days] (p < 0.05). Complications occurred in 19 (79%) of infants and included renal failure (19, 79%), seizures (3, 13%) and intraventricular haemorrhage (1, 4%), and one died (4%). Hypernatraemic dehydration is an uncommon complication of failure to establish breastfeeding but is associated with severe morbidity and mortality. Education programmes are needed to increase awareness amongst health-care workers and mothers in order to prevent the problem.
authors.affiliation: Section of Child Health, Department of Obstetrics, Gynaecology and Child Health, University of the West Indies, Mona, Kingston, Jamaica. helen.trotmanedwards@uwimona.edu.jm
authors.forename: H
authors.initials: H
authors.lastname: Trotman
authors.forename: C
authors.initials: C
authors.lastname: Lord
authors.forename: M
authors.initials: M
authors.lastname: Barton
authors.forename: M
authors.initials: M
authors.lastname: Antoine
mesh_terms: D000138:Acidosis / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D001942:Breast Feeding; D003681:Dehydration / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006699:Home Care Services; D006801:Humans; D006955:Hypernatremia / Q000150:complications / Q000453:epidemiology*; D015994:Incidence; D007231:Infant, Newborn; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D011295:Prenatal Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D015431:Weight Loss / Q000502:physiology
chemical_list: D012964:Sodium