Hypernatraemic dehydration and breast feeding: a population study

Oddie, Sam

doi:10.1136/adc.85.4.318

Cited by 127 publications

(119 citation statements)

References 24 publications

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“…The findings of the current study are consistent with previous reports (11,15) stating that most of the mothers of the neonates with excessive weight loss were primiparas. Therefore, first-time mothers should receive more reassurance and practical advice in the technique of breast-feeding.…”

Section: Discussionsupporting

confidence: 83%

“…Along with other studies, the present one showed that fever (12,13) and hypernatremia (5,8,(10)(11)(12)(13)(14) are often found in neonates with excessive weight loss. In low-risk fullterm infants, fever with no other symptoms during the first days of life is related primarily to dehydration and breast-feeding, whereas infection is the least common explanation (13).…”

Section: Discussionmentioning

confidence: 85%

“…Not uncommonly, this can result in catastrophic outcomes for exclusively breast-fed infants. Both anecdotal reports (5)(6)(7)(8)(9) and recent retrospective (10)(11)(12)(13) and prospective (14,15) studies indicate an increase in frequency and severity of outcomes of this imbalance.…”

Section: Introductionmentioning

confidence: 99%

“…Data in all these studies have been derived from the records of community-based newborn follow-ups (4,15) and hospital admissions (5,(7)(8)(9)(10)(11)(12)(13)(14). In the current study, we determined the risk factors for excess weight loss and hypernatremia in exclusively breastfed infants who attended our clinic.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

Cağlar

Özer

Altugan

2006

Braz J Med Biol Res

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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 ≥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.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

Cağlar

Özer

Altugan

2006

Braz J Med Biol Res

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“…Dehydration is usually defined as a weight loss of more than 10% of the birth weight [2,10,16]. The data currently available are very variable with respect to the incidence reported [3,8,10,15,16,18,20]. The studies cannot be compared with one another due to large differences in study designs and the populations examined, and due to the differing practices of various countries concerning medical care of the newborn.…”

Section: Introductionmentioning

confidence: 96%

Prevention of hypernatraemic dehydration in breastfed newborn infants by daily weighing

2008

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Hypernatraemic dehydration, which predominantly appears in breastfed neonates, can cause serious complications, such as convulsions, permanent brain damage and death, if recognised late. Weight loss ≥10% of birth weight could be an early indicator for this condition. In this prospective cohort study from October 2003 to June 2005 in the postnatal ward of the University Hospital Zurich, Switzerland, all term newborns with birth weight ≥2,500 g were weighed daily until discharge. When the weight loss was ≥10% of birth weight, serum sodium was measured from a heel prick. Infants with moderate hypernatraemia (serum sodium=146-149 mmol/l) were fed supplementary formula milk or maltodextrose 10%. Infants with severe hypernatraemia (serum sodium ≥150 mmol/l) were admitted to the neonatal unit and treated in the same way, with or without intravenous fluids, depending on the severity of the clinical signs of dehydration. A total of 2,788 breastfed healthy term newborns were enrolled. Sixty-seven (2.4%) newborns had a weight loss ≥10% of birth weight; 24 (36%) of these had moderate and 18 (27%) severe hypernatraemia. Infants born by caesarean section had a 3.4 times higher risk for hypernatraemia than those born vaginally. All newborns regained weight 24 h after additional fluids. Conclusion: In our study, one out of 66 healthy exclusively breastfed term neonates developed hypernatraemic dehydration. Daily weight monitoring and supplemental fluids in the presence of weight loss ≥10% of birth weight allows early detection and intervention, thereby preventing the severe sequellae of hypernatraemic dehydration.

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