Charts for weight loss to detect hypernatremic dehydration and prevent formula supplementing.
BACKGROUND
Most breast-fed newborns get the milk they need. However, very rarely milk intake is insufficient mostly as a result of poor breastfeeding techniques. Dramatic weight loss and hypernatremic dehydration may occur. Our aim was to construct charts for weight loss.


METHODS
A case-control study was performed. Charts with standard deviation score (SDS) lines for weight loss in the first month were constructed for 2,359 healthy breast-fed term newborns and 271 cases with breastfeeding-associated hypernatremic dehydration with serum sodium level > 149 mEq/L. Day 0 was defined as the day of birth.


RESULTS
Many cases with (or who will develop) hypernatremic dehydration (84%; +1 SDS line) fell below the -1 SDS line at day 3, the -2 SDS line at day 4, and the -2.5 SDS line at day 5 in the chart of the healthy breast-fed newborns. Weight loss of cases with permanent residual symptoms was far below the -2.5 SDS.


CONCLUSIONS
Already at an early age, weight loss differs between healthy breast-fed newborns and those with hypernatremic dehydration. Charts for weight loss are, therefore, useful tools to detect early, or prevent newborns from developing, breastfeeding-associated hypernatremic dehydration, and also to prevent unnecessary formula supplementing.
Department of Life Style, TNO, Leiden, The Netherlands.
Paula
P
van Dommelen
Suzanne
S
Boer
Sevim
S
Unal
Jacobus P
JP
van Wouwe
D015415:Biomarkers / Q000097:blood; D001942:Breast Feeding / Q000009:adverse effects*; D016022:Case-Control Studies; D003681:Dehydration / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D057238:Growth Charts; D006801:Humans; D006955:Hypernatremia / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D041943:Infant Formula; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D015431:Weight Loss
D015415:Biomarkers; D012964:Sodium
breastfeeding; dehydration; growth