University of Oran 1, Algeria
* Corresponding author
University of Oran 1, Algeria
University of Oran 1, Algeria

Article Main Content

Introduction: Dehydration (DSH) in newborns can have potentially fatal consequences such as cerebral oedema, intracranial haemorrhage, subdural haematoma, hydrocephalus and gangrene. In light of the increasing number of newborns with dehydration, there is a strong need to increase awareness and raise suspicion in the diagnosis of this potentially fatal condition. 

Objective: To describe dehydration in the newborn, its complications and the method of appropriate management. 

Patients and method: Retrospective descriptive and analytical study, from January 1, 2019 to May 31, 2021.

Study population: We included all newborns and infants aged 0 to 30 days, hospitalized during the period with clinical and biological signs of dehydration. Hypernatremia was defined by a natremia ≥ 150 mmol/L. Data were collected in Excel and analysed using R 3.5.0 software.

Conclusion: Neonatal dehydration is not as rare as is commonly believed. Feeding difficulties in newborns may result in inadequate secretion of sodium into the breast milk. Monitoring the mother and newborn in the first week of life for successful establishment of breastfeeding is essential. In an otherwise healthy newborn, poor feeding and weight loss may be a reason to suspect hypernatremia. Neonatal hypernatremia due to breast milk hypernatremia is now a well-established entity and should be sought in all newborns with hypernatremia. There is no reason to stop breastfeeding even if the sodium level in the breast milk is high as it decreases over time. Breastfeeding is still extremely beneficial for the baby and should be strongly recommended.

References

  1. Escobar GJ, Gonzales VM, Armstrong MA, Folck BF, Xiong B, Newman TB. Rehospitalization for neonatal dehydration: a nested case-control study. Arch Pediatr Adolesc Med. 2002; 156: 155-61.
     Google Scholar
  2. Oddie SJ, Craven V, Deakin K, Westman J, Scally A. Severe neo- natal hypernatremia: a population-based study. Arch Dis Child Fetal Neonatal. 2013; 98(5): F384-7.
     Google Scholar
  3. Reilev M, Børch K, Pryds OA. Neonatal hypernatraemic dehydration-why increasing incidence. Ugeskr Laeger. 2007; 169(13): 1227-31.
     Google Scholar
  4. Laing IA, Wong CM. Hypernatremia in the first few days: is the incidence rising. Arch Dis Child Fetal Neonatal Ed. 2002; 87(3): F158-62.
     Google Scholar
  5. Ballot DE, Davies VA, Cooper PA, Chirwa T, Argent A, Mer M. Retrospective cross-sectional review of survival rates in criti- cally ill children admitted to a combined paediatric/neonatal intensive care unit in Johannesburg, South Africa, 2013—2015. BMJ Open. 2016; 36(6): e010850.
     Google Scholar
  6. Ergenekon E, Unal S, Gucuyener K, Soysal SE, Koc E, Okumus N, et al. Hypernatremic dehydration in the newborn period and long-term follow up. Pediatr Int. 2007; 49(1): 19-23.
     Google Scholar
  7. Finberg L. Neonatal neurologic damage after dehydration. J Pediatr. 2007; 151(2): 110-1.
     Google Scholar
  8. Bolat F, Oflaz M, Guven AS, Ozdemir, Alaygut D, Dogan MT, et al. What is the safe approach for neonatal hypernatremic deshy- dratation? A retrospective study from a neonatal intensive care unit. Pediatr Emerg Care. 2013; 29(7): 808-13.
     Google Scholar
  9. Dewey KG, Nommsen-Rivers LA, Heinig MJ, Cohen RJ. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics. 2003; 112(3): 607-19.
     Google Scholar
  10. Ng PC, Chan HB, Fok TF, Lee CH, Chan KM, Wong W, et al. Early onset of hypernatraemic dehydration and fever in exclusively breastfed infants. J Paediatr Child Health. 1999; 35(6): 585-7.
     Google Scholar
  11. Boskabadi MG, Ebrahimi M, Ghayour-Mobarham M, Esmaeily H, Sahebkar A, et al. Neonatal hypernatremia and dehydration in infants receiving inadequate breastfeeding. Asia Pac J Clin Nutr. 2010; 19(3): 301-7.
     Google Scholar
  12. Oddie S, Richmond S, Coulthard M. Hypernatraemic dehydration and breast feeding: a population study. Arch Dis Child. 2001; 85(4): 318-20.
     Google Scholar
  13. Trotman H, Lord C, Barton M, Antoine M. Hypernatraemic dehy- dration in Jamaican breastfed neonates: a 12-year review in a baby-friendly hospital. Ann Trop Paediatr. 2004; 24: 295-300.
     Google Scholar
  14. Unal S, Arhan E, Kara N, Uncu N, Aliefendioglu D. Breastfeeding-associated hypernatremia: retrospective analysis of 169 term newborns. Pediatr Int. 2008; 50: 29-34.
     Google Scholar
  15. Agence nationale de la statistique et de la démographie (ANSD) (Sénégal), ICF. Sénégal : enquête démographique et de santé continue (EDS-Continue 2017). Rockville, Maryland, USA: ANSD et ICF; 2018. French.
     Google Scholar
  16. Aufrant C, Bompard Y. Dénutrition déshydratation et allaite- ment maternel. J Pediatr Pueric. 1999; 12: 4-9. French.
     Google Scholar
  17. Moritz ML, Manole MD, Bogen DL, Ayus DL. Breastfeeding asso- ciated hypernatremia: are we missing the diagnosis? Pediatrics. 2005; 116: 343-7.
     Google Scholar
  18. Manganaro R, Mami C, Marrone T, Marseglia L, Gemelli M. Incidence of dehydration and hypernatremia in exclusively breast-fed infants. J Pediatr 2001; 139: 673-5.
     Google Scholar
  19. Konetzny G, Bucher HU, Arlettaz R. Prevention of hyperna- traemic dehydration in breastfed newborn infants by daily weighing. Eur J Pediatr. 2009; 168(7): 815-8.
     Google Scholar
  20. Lavagno C, Camozzi P, Renzi S, Lava SA, Simonetti GD, Bianchetti MG. Breastfeeding-associated hypernatremia: a systematic review of the literature. J Hum Lact. 2016; 32(1): 67-74.
     Google Scholar
  21. Abu-Salah O. High breast milk sodium concentration resulting in neonatal hypernatraemic deshydration. East Mediterr Health J. 2001; 7: 841-3.
     Google Scholar
  22. Peker E, Kirimi E, Tuncer O, Ceylan A. Severe hypernatremia in newborns due to salting. Eur J Pediatr. 2010; 169(7): 829-32.
     Google Scholar
  23. Livingstone VH, Willis CE, Abdel-Wareth LO, Thiessen P, Lockitch G. Neonatal hypernatremic dehydration associated with breastfeeding malnutrition: a retrospective survey. CMAJ. 2000; 162: 647-52.
     Google Scholar
  24. Unver Korgalı E, Cihan MK, Oguzalp T, Sahinbas A, Ekici M. Hypernatremic dehydration in breastfed term infants: retrospective evaluation of 159 cases. Breastfeed Med. 2017; 12: 5-11.
     Google Scholar
  25. Hall RT, Simon S, Smith MT. Readmission of breastfed infants in the first 2 weeks of life. J Perinatol. 2000; 20(7): 432-7.
     Google Scholar
  26. Bhat SR, Lewis P, David A, Liza SM. Dehydration and hypernatremia in breast-fed term healthy neonates. Indian J Pediat. 2006; 73(1): 39-41.
     Google Scholar
  27. Boussoffara R. Déshydratation aiguë du nourrisson: étude com- parative de 444 cas sur trois périodes en Tunisie. Arch Pediatr. 2008; 15: 942. French.
     Google Scholar
  28. Zachariassen G, Juvonen P. Neonatal dehydration (dehydration fever) in newborn infants. Ugeskr Laeger. 2002; 164: 4930-4.
     Google Scholar
  29. Erdemir A, Kahramaner Z, Cosar H, Turkoglu E, Kanik A, Sutcuoglu S, et al. Comparison of oral and intravenous fluid therapy in newborns with hypernatremic dehydration. J Matern Fetal Neonatal Med. 2014; 27: 491-4.
     Google Scholar
  30. Bülbül A, Can E, Uslu S, Asiye N. Hypernatremic dehydratation in term infants. Turk Arch Ped. 2009; 44: 84-8.
     Google Scholar
  31. Boskabadi H, Anvarifar F, Nourizadeh N. Could neonatal hypernatremia deshydration influence hearing status. Iran J Otorchinolaryngol. 2014; 26(74): 13-8.
     Google Scholar
  32. Boskabadi H, Akhondian J, Afarideh M, Maamouri G, Bagheri S, Parizadeh SM, et al. Long-term neurodevelopmental outcome of neonateswith hypernatremic dehydration. Breastfeed Med. 2017; 12: 163-8.
     Google Scholar
  33. Korkmaz A, Yigit S, Firat M, Oran O. Cranial MRI in neonatal hypernatraemic dehydration. Pediatr Radiol. 2000; 30: 323-5.
     Google Scholar
  34. Boumanhil B, Pharaly S, Randrianaly H, Robillard PY, Renouil M. Déshydratation hypernatrémique et allaitement maternel. Arch Pediatr. 2001; 8: 731-3. French.
     Google Scholar