Neonatal hypernatremia and dehydration in infants receiving inadequate breastfeeding.
BACKGROUND
Neonatal hypernatermic dehydration (NHD) is a potentially very serious condition, which has been reported to occur in infants who have breast feeding problems in the first week of the life. This study looked at the incidence, risk factors, clinical symptoms and complications of NHD in healthy breastfed term neonates.


METHODS
A prospective case-control study was conducted on 53 neonates with serum sodium concentrations of >or=150 mmol/L (as the case group) who were recruited between June 2006 and June 2007 from the Ghaem hospital (Mashhad, Iran) to investigate the relationship between NHD and breastfeeding. Fifty-three healthy breastfed full-term neonates (serum sodium<150 mmol/L) from the same hospital were also recruited as the control group.


RESULTS
The results showed an average weight loss of 1.6% in the healthy neonates vs. 16.2% in infants with NHD (p<0.001). The frequency of feeds received per day was 10.2 for the healthy neonates vs. 7.6 in the NHD group (p<0.001). The NHD group had mothers who had a higher frequency of breast problems (23 vs. 7, p<0.001). Mean serum sodium concentration was significantly lower in the control group compared with the cases (137.80 vs.160.06 mmol/L, p<0.001). The main presenting features of the infants with NHD were fever, lethargy and jaundice.


CONCLUSIONS
Breastfeeding problems are associated with the presence of NHD. Therefore, more breast examination during prenatal and postnatal periods and careful neonatal weight watch during the first week of life could decrease the incidence of NHD.
Boskabadi
Hassan
H
Ghaem Hospital, and Department of Biochemistry and Nutrition, Faculty of Medicine, Mashhad University of Medical Science (MUMS), Mashhad, Iran.
Maamouri
Gholamali
G
Ebrahimi
Mansour
M
Ghayour-Mobarhan
Majid
M
Esmaeily
Habib
H
Sahebkar
Amirhossein
A
Ferns
Gordon A A
GA
D000328:Adult; D001942:Breast Feeding; D016022:Case-Control Studies; D003681:Dehydration / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000453:epidemiology / Q000209:etiology*; D007231:Infant, Newborn; D007775:Lactation Disorders / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D015431:Weight Loss