Hypernatremia in Neonates Getting Exclusive Breastfeeding

摘要

Background: Neonatal hypernatremia and hypernatremic dehydration is a potentially fatal condition which adversely affects the central nervous system, leading to devastating consequences like intracranial hemorrhage, thrombosis and death. Hypernatremia previously thought to be unusual in exclusively breast-fed neonate but recently the incidence of hypernatremia and hypernatremic dehydration is rising. Hypernatremic dehydration is the most dangerous form of dehydration because of complications of hypernatremia itself and of its therapy. Clinical presentation is variable. Some present with lethargy;others are alert and hungry. This study emphasized the importance of early recognition and timely intervention of neonatal breast milk hypernatremia significantly reduces the consequences. Aim: Assessment hypernatremia and hypernatremic dehydration in neonate’s receiving exclusive breastfeeding. Methods: It was a retrospective study carried out in the Neonatal Intensive Care Unit (NICU) of North East Medical College Hospital (NEMCH), Sylhet, Bangladesh during the period of JA20210918nuary 2018 to June 2019 who were investigated and found to have hypernatremia and whose mother’s breast milk sodium and serum sodium was also done. Neonate who on exclusively breast feed with serum sodium ≥ 150 mmol/l, normoglycemic, normocalcemic, no clinical and laboratory evidence of sepsis were included in this study. Results: Elevated breast milk sodium strongly interrelated with neonatal hypernatremia in exclusively breast-fed neonates. Conclusion: This study concludes the need for early recognition of hypernatremia and judicious fluid management is essential for better prognosis and highlighted the elevated breast milk sodium is an important etiological factor.