Inadequate Breastfeeding Associated Hypernatraemia; an Outcome

Objective: To determine the frequency of hypernatraemic dehydration in inadequate breastfed infants. Methods: This was a cross-sectional study conducted in Neonatal Intensive Care Unit (NICU) of Liaquat National Hospital, Karachi over a period of one year from January to December 2015. Ethical committee approval was obtained. The inclusion criteria include all neonates (age 28 days of life) who consume human milk with no supplementation of any type (no water, no non human milk) since birth were included. Moreover, neonates with serum sodium level >150 mEq/L was also a part of inclusion criteria. The exclusion criteria include all neonates who are preterm or infants (age >28 days of life) or neonates with any other birth related issues such as congenital malformation, inborn errors of metabolism, renal disease were excluded. Results: 58 neonates with hypernatraemic dehydration were enrolled in study, the major symptom 32 (55%) babies were presented with decreased urine output followed by fever, jaundice, weight loss, lethargy, seizures and decrease urinary output. With respect to serum sodium levels, most babies fall in the category of (150-160 mEq/L) which constitutes about 24 babies. Hypernatraemic dehydration affects more male babies than female babies with 38 (65.51%) and 20 (34.48%) respectively. Moreover, according to our study, babies born to primiparous women are more likely to be affected with hypernatraemic dehydration than multiparous women. Furthermore, maximum number of babies who suffered from hypernatraemic dehydration had age presentation of 11-20 days of life, followed by 1-10 days and 21-30 respectively. Conclusion: Breastfeeding associated hypernatraemic dehydration is a serious condition with many serious complications and even results in death if detected late. It is recommended to have routine weight checks at 2, 3, 5 and 10 days of life to identify babies at risk. Lactation counselling should be an essential part of antenatal care being provided to pregnant women, to prepare them to undertake this highly beneficial activity with proper technique and with pride and confidence.