Neonatal hypernatraemic dehydration

Panagoda, Ranga; Cure, Natalie De; McCuaig, Ruth; Kent, Alison

doi:10.1111/jpc.12918

Cited by 3 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Neonatal hypernatremia is an uncommon finding and it has been frequently associated with breastfeeding failure and weight loss. [10][11][12] In our case, the extreme hypernatremia could not fully be explained only by weight loss. Other differential diagnoses were salt poisoning (rare in a young infant), diarrhea, and polyuria (in cases of diabetes insipidus; ►Fig.…”

Section: Discussioncontrasting

confidence: 59%

Severe Hypernatremia as Presentation of Netherton Syndrome

Di Nora,

Consentino,

Messina

et al. 2023

Glob Med Genet

View full text Add to dashboard Cite

Netherton syndrome is a rare, multisystem, autosomal recessive genodermatosis characterized by a triad of manifestations: congenital ichthyosis, immune dysregulation, and scalp anomalies. We report the case of a 1-month-old male infant evaluated for failure to thrive and feeding difficulties. At birth, the infant was admitted to intensive care for severe hypernatremia (natremia 186 mg/dL). Upon entering the ward, the general conditions were poor. He presented with diffuse erythrodermia. A dermatological evaluation showed evidence of “invaginated trichuriasis,” a typical sign of Netherton syndrome. Netherton syndrome is caused by a genetic mutation causing loss of function of the SPINK5 gene it encodes for the LEKTI protein, normally expressed in epithelia. Loss of LEKTI induces severe skin barrier defect. The history of the disease is characterized by serious potential complications in the first months of life, such as the risk of hypernatremic dehydration induced by high skin permeability, recurrent and/or severe infections, and growth retardation.

show abstract

Section: Discussioncontrasting

confidence: 59%

Severe Hypernatremia as Presentation of Netherton Syndrome

Di Nora,

Consentino,

Messina

et al. 2023

Glob Med Genet

View full text Add to dashboard Cite

show abstract

“…Verd et al ended their letter by suggesting that current knowledge cannot support that any pronounced birth weight loss points at breastfeeding failure and therefore warrants formula supplementation. We disagree with this point as a serious outcome of unrecognized feeding problems and too much weight loss can be hypernatremic dehydration (Panagoda, De Cure, McCuaig, & Kent, 2015). In our study, mean weight loss for newborns who lost > 7% ( n = 84) was 9.3% ± 2%.…”

mentioning

confidence: 99%

Reply to “Does Pronounced Birth Weight Loss Indicate Breastfeeding Failure?”

DiTomasso¹,

Paiva²

2017

J Hum Lact

View full text Add to dashboard Cite

Famous 16th-century scientist and philosopher Frances Bacon noted how, at times, the remedy to a problem could be worse than the disease. We believe this speaks to the point by Verd et al. when they suggest that supplementing breastfed newborns with formula to avoid the "danger zone" of too much weight loss presents another danger of formula supplementation. Indeed, the interruption of breastfeeding by the introduction of formula can have serious and lifelong repercussions for both mother and infant. The decision to begin supplementation for breastfed newborns should not be taken lightly and, as noted by Verd and colleagues, should include more than just an evaluation of infant weight. The newborn's latch to the breast, milk transfer, outputs, and satiety after feedings, as well as weight checks, should all be part of a comprehensive feeding evaluation.In their letter to the editor, Verd et al. described how very few studies have collected breastfeeding outcomes beyond hospital discharge. They noted how our findings and those by Flaherman et al. ( 2017) "favor equal ability to breastfeed among mothers of infants irrespective of their birth weight loss." We were able to show that newborns gained weight at a similar pace, despite differences in early weight loss. These are critical preliminary findings that suggest that healthy term neonates have a greater capacity to cope and recover from weight loss than previously believed.It should also be noted that Flaherman et al. showed that exacerbated weight loss was strongly associated with decreased likelihood of exclusive breastfeeding. These findings collaborate with our own, which showed that on Day 14, the exclusive breastfeeding rate for newborns who lost > 7% of their birth weight was significantly less than for infants who lost ≤ 7%. These results support the belief that weight loss is a driving force behind formula supplementation. What must be stressed, however, is our lack of understanding regarding expected neonatal weight loss. According to the American Academy of Pediatrics (2012), weight loss for healthy breastfed newborns should be no more than 7%. Yet, in our two studies of more than 400 newborns, we were able to demonstrate that more than half of healthy term breastfed newborns lost more than the conventional 7% (DiTomasso & Paiva, 2017;Thulier, 2017). We therefore propose that inaccurate beliefs about neonatal weight changes for breastfed newborns may be contributing to lower breastfeeding rates in the United States.

show abstract

Weight loss monitoring reduces the occurrence of neonatal hypernatremic dehydration in breastfeeding neonates

Zia

Golombek

Nitkowski-Keever

et al. 2022

International Journal of Pediatrics and Adolescent Medicine

View full text Add to dashboard Cite

Background: Excessive weight loss enhances the incidence of neonatal hypernatremic dehydration (NHD). We compared the effect of a new breastfeeding policy against an old breastfeeding policy on neonatal weight change and the incidence of NHD. Methods: This was a QA project between two sets of breastfeeding (BF) protocols for exclusively BF newborns. Under our old BF policy, a number of neonates had a significant loss of weight after birth and were admitted to the NICU due to NHD. We implemented a new BF policy that was used when a newborn loses>5% of previously recorded weight within a 24-h interval. Two groups were compared: the preintervention group (old BF policy) and postintervention group (new BF policy). Additionally, characteristics of newborns admitted to NICU were separately compared with the subgroup of pre- and post intervention dehydration groups. Results: Preintervention = 1320 and postintervention = 1450. Neonates with weight loss of > 5% within the first 24-h time interval were higher in the postintervention group (19.7%) as compared to the pre-intervention group (10.2%) (P < .05). However, the number of infants diagnosed to have NHD was lower in the postintervention group (0.68%) than in the preintervention group (1.66%), (P < .03). Neonatal characteristics were comparable between subgroups of dehydration. Conclusion: An intervention at ≥ 5% neonatal weight loss markedly reduces the incidence of NHD- associated NICU admissions.

show abstract

Neonatal hypernatraemic dehydration

Cited by 3 publications

References 8 publications

Severe Hypernatremia as Presentation of Netherton Syndrome

Severe Hypernatremia as Presentation of Netherton Syndrome

Reply to “Does Pronounced Birth Weight Loss Indicate Breastfeeding Failure?”

Weight loss monitoring reduces the occurrence of neonatal hypernatremic dehydration in breastfeeding neonates

Contact Info

Product

Resources

About