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CMAJ. 2000 Mar 7;162(5):647-52.

Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey.

Author information

  • 1Department of Family Practice, University of British Columbia, Vancouver. vlivings@direct.ca

Abstract

BACKGROUND:

Hypernatremic dehydration in neonates is a potentially devastating condition. Recent reports have identified breast-feeding malnutrition as a key factor in its pathophysiology.

METHODS:

Using a theoretical framework for breast-feeding kinetics, a retrospective chart review of all neonates less than 28 days of age who were seen at either British Columbia's Children's Hospital or the Vancouver Breastfeeding Centre between 1991-1994 was conducted to identify and classify possible causes of breast-feeding malnutrition among neonates who developed hypernatremic dehydration.

RESULTS:

Twenty-one cases hypernatremic dehydration were identified. Infant weight loss ranged from 8% to 30% of birth weight, and serum sodium levels ranged from 146 mmol/L to 207 mmol/L. In each case, maternal or infant factors (e.g., poor breast-feeding technique, lactation failure following postpartum hemorrhage and infant suckling disorders associated with cleft palate or ankyloglossia) that could interfere with either lactation or breast-feeding dynamics and account for insufficient breast milk intake were identified.

INTERPRETATION:

Prenatal and in-hospital screening for maternal and infant risk factors for breast-feeding malnutrition combined with early postpartum follow-up to detect excessive infant weight loss are important for the prevention of neonatal hypernatremic dehydration.

PMID:
10738450
[PubMed - indexed for MEDLINE]
PMCID:
PMC1231219
Free PMC Article
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