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Neonatal Hypernatremia in Exclusively Breastfed Newborns- A Case Control Study in the Postnatal Ward of a Tertiary Care Hospital |
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| Correspondence
Address : Dr. Neha Mohan Rao, 588 7th main 17th cross Indiranagar, 2nd stage, Bangalore-560038, Karnataka, India. E-mail: neharao89@gmail.com |
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Introduction: Hypernatremia, defined as a serum sodium level of more than 145 mEq/L, is a common but potentially dangerous condition in newborns. Hypernatremia in exclusively breastfed newborns is usually secondary to insufficient lactation. Aim: To determine the clinical profile and risk factors associated with the development of hypernatremia and to assess whether neonatal hypernatremia is associated with breastfeeding problems. Materials and Methods: This was a case control study conducted in the postnatal ward of Bangalore Baptist Hospital, Bengaluru, Karnataka, India on 64 exclusively breastfed newborns (32 cases and 32 controls), between September 2017 and June 2018. In babies with significant weight loss (more than 10% in term or more than 15% in late preterm), or symptoms suggestive of dehydration like depressed anterior fontanel, excessive cry, lethargy, poor feeding, serum sodium levels of the newborn was measured. Babies with serum sodium >150 mmol/L were in the case group and babies with sodium <145 mmol/L were in the control group. Corresponding breast milk sodium levels were measured and classified into normal or high breast milk sodium based on standard cut-offs. LATCH score of each mother-infant dyad was observed to assess breastfeeding. Maternal and neonatal risk factors were assessed and data interpreted. The data collected was then analysed using Microsoft Excel and SPSS software (version 18). Results: On comparing breast milk sodium levels with standard normal levels, it was found that- amongst mothers with high breast milk sodium, 55.55% babies had hypernatremia, versus mothers with normal breast milk sodium, where only 20% babies had hypernatremia. This was found to be statistically significant (p=0.038) indicating an association between high breast milk sodium and hypernatremia. Conclusion: Breastfeeding associated hypernatremia is a preventable cause of morbidity in the newborn. Mothers with high breast milk sodium are more likely to have babies with hypernatremia than mothers with normal breast milk sodium levels. |
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