[Hypernatremic dehydration associated with breast-feeding].

Abstract

BACKGROUND: During the last 10 years the number of publications reporting a rise in the incidence of hypernatremia in children who are exclusively breast-fed has increased. OBJECTIVE: To report the results of a series of cases detected in a district hospital in the last 6 years in order to better delineate the clinical characteristics of infant hypernatremia, its optimal treatment and preventive measures. MATERIAL AND METHODS: The selection criteria for our study included all neonates aged less than 30 days with serum sodium concentrations equal to or greater than 150 mEq/mL who were exclusively breast fed. Cases were identified through the departmental database. RESULTS: Twelve newborns were identified who presented the following characteristics: mean gestational age of 39.5 weeks, mean birth weight of 3440 grams, mean percentage of weight loss from birth 13.7 % and mean serum sodium value 152.75 mEg/mL. Five neonates (42 %) were admitted from the maternity unit and seven (58 %) from the emergency department. The presenting complaints included weight loss in nine infants, irritability in six, fever in six, poor feeding in five and jaundice in two. Most of the neonates had more than one symptom. Ten of the mothers (83.33 %) were primiparous and two (16.67 %) were secundiparous. CONCLUSIONS: Hypernatremia due to breast-feeding is a consequence of inadequate breast-feeding technique in inexperienced mothers. A possible solution would be for health professionals to provide mothers with greater support.