Malnutrition and hypernatraemia in breastfed babies

Despite the well-known advantages of breast-feeding to both mother and infa nt, malnutrition of breastfed infants does occur. We report two term neonat es who presented in the 3rd week of life with severe wasting, hypernatraemi c dehydration and pre-renal failure while being exclusively breastfed. Brea st-milk sodium levels were markedly elevated on admission. Both infants rec overed following adequate hydration and showed excellent catch-up growth du ring follow-up while exclusive breast-feeding was maintained. The critical malnutrition in both cases was detected by the family physician during rout ine postnatal visits. Both mothers were well motivated toward breast-feedin g and were unaware of the severity of the baby's illness.