Vh. Livingstone et al., Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey, CAN MED A J, 162(5), 2000, pp. 647-652
Citations number
33
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background: Hypernatremic dehydration in neonates is a potentially devastat
ing condition. Recent reports have identified breast-feeding malnutrition a
s a key factor in its pathophysiology.
Methods: Using a theoretical framework for breast-feeding kinetics, a retro
spective chart review of all neonates less than 28 days of age who were see
n at either British Columbia's Children's Hospital or the Vancouver Breastf
eeding Centre between 1991-1994 was conducted to identify and classify poss
ible causes of breast-feeding malnutrition among neonates who developed hyp
ernatremic dehydration.
Results: Twenty-one cases hypernatremic dehydration were identified. Infant
weight loss ranged from 8% to 30% of birth weight, and serum sodium levers
ranged from 146 mmol/L to 207 mmol/L. In each case, maternal or infant fac
tors (e.g., poor breast-feeding technique, lactation failure following post
partum hemorrhage and infant suckling disorders associated with cleft palat
e or ankyloglossia) that could interfere with either lactation or breast-fe
eding dynamics and account for insufficient breast milk intake were identif
ied.
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 pre
vention of neonatal hypernatremic dehydration.