مرکز منطقه ای اطلاع رساني علوم و فناوري - Clinical findings and treatment recommendations of hypernatremic dehydration due to breast milk

Abstract :

Objectives: In this study, we aimed to assess the incidence, presenting complaints, risk factors of hypernatremic dehydration (DH), and to stage the degree of hypernatremic DH among term, exclusively breast feeding infants, and to suggest a therapy for hypernatremic DH. Methods: Term, exclusively breast feeding neonates admitted to our neonatology policlinics, with a more than 7% weight loss, serum sodium concentrations of ≥147 mEq/L were allocated for the study. ‘Maternals and infants’ medical history, examination, including presenting complaints, risk factors, stool- urine frequency, weight loss, the duration of the treatment, the rate of sodium decrease by hourly was calculated and recorded. Percentage of weight loss by taking into account, degree of DH (mild, moderate, severe) was created. Results: Dehydration were determined in 126 of 3642 patients (3.5%). Patients were allocated as Group 1, mild DH (n=59, 47%), group 2, moderate DH (n=43, 34%), group 3, severe DH (n=24, 19%). Relevant clinical fi ndings on admission were jaundice (46.8%), fever (42%), poor oral feeding (36.5%), reduction in the amount of stool- urination (32.5%). Clinical fi ndings of dehydration were more frequent than other groups in group 3. On the admission day, postnatal age, blood urea, creatinine levels, duration of the therapy, sodium levels were higher than other groups in group 3. Intravenous (IV) fl uid requirement was over than other groups in group 3. Only two patients had seizures in the severe DH group. Positive correlation was determined between percentage of weight loss and serum sodium, urea and creatinine levels Conclusion: Diagnosis of hypernatremic DH is delayed, because of no obvious signs of dehydration is present in the early period. There is no specifi c sign to determine the degree of DH. Weight loss is the most prominent fi nding, accompanied by jaundice, fever, a decrease in urine and stool frequencies. Creation of a common treatment protocol is the solution of questions in minds.