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.
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.
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.
Reilev M, Børch K, Pryds OA. Neonatal hypernatraemic dehydration-why increasing incidence. Ugeskr Laeger. 2007; 169(13): 1227-31.
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.
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.
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.
Finberg L. Neonatal neurologic damage after dehydration. J Pediatr. 2007; 151(2): 110-1.
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.
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.
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.
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.
Oddie S, Richmond S, Coulthard M. Hypernatraemic dehydration and breast feeding: a population study. Arch Dis Child. 2001; 85(4): 318-20.
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.
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.
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.
Aufrant C, Bompard Y. Dénutrition déshydratation et allaite- ment maternel. J Pediatr Pueric. 1999; 12: 4-9. French.
Moritz ML, Manole MD, Bogen DL, Ayus DL. Breastfeeding asso- ciated hypernatremia: are we missing the diagnosis? Pediatrics. 2005; 116: 343-7.
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.
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.
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.
Abu-Salah O. High breast milk sodium concentration resulting in neonatal hypernatraemic deshydration. East Mediterr Health J. 2001; 7: 841-3.
Peker E, Kirimi E, Tuncer O, Ceylan A. Severe hypernatremia in newborns due to salting. Eur J Pediatr. 2010; 169(7): 829-32.
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.
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.
Hall RT, Simon S, Smith MT. Readmission of breastfed infants in the ﬁrst 2 weeks of life. J Perinatol. 2000; 20(7): 432-7.
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.
Boussoffara R. Déshydratation aiguë du nourrisson: étude com- parative de 444 cas sur trois périodes en Tunisie. Arch Pediatr. 2008; 15: 942. French.
Zachariassen G, Juvonen P. Neonatal dehydration (dehydration fever) in newborn infants. Ugeskr Laeger. 2002; 164: 4930-4.
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.
Bülbül A, Can E, Uslu S, Asiye N. Hypernatremic dehydratation in term infants. Turk Arch Ped. 2009; 44: 84-8.
Boskabadi H, Anvarifar F, Nourizadeh N. Could neonatal hypernatremia deshydration inﬂuence hearing status. Iran J Otorchinolaryngol. 2014; 26(74): 13-8.
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.
Korkmaz A, Yigit S, Firat M, Oran O. Cranial MRI in neonatal hypernatraemic dehydration. Pediatr Radiol. 2000; 30: 323-5.
Boumanhil B, Pharaly S, Randrianaly H, Robillard PY, Renouil M. Déshydratation hypernatrémique et allaitement maternel. Arch Pediatr. 2001; 8: 731-3. French.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.