title: Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants.
abstract: Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss > or = 10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05), primiparity (P < 0.005), less than four stools (P < 0.001), pink diaper (P < 0.001), delay at initiation of first breast giving (P < 0.01), birth by cesarean section (P < 0.05), extra heater usage (P < 0.005), extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001), mean weight loss in neonates with pink diaper (P < 0.05), mean uric acid concentration in neonates with pink diaper (P < 0.0001), fever in hypernatremic neonates (P < 0.02), and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02) were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey. mkc@ttnet.net.tr
authors.forename: M K
authors.initials: MK
authors.lastname: Caglar
authors.forename: I
authors.initials: I
authors.lastname: Ozer
authors.forename: F S
authors.initials: FS
authors.lastname: Altugan
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects*; D003681:Dehydration / Q000209:etiology; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D012307:Risk Factors; D015431:Weight Loss