TY - JOUR T1 - Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey JF - Canadian Medical Association Journal JO - CMAJ SP - 647 LP - 652 VL - 162 IS - 5 AU - Verity H. Livingstone AU - Claire E. Willis AU - Laila O. Abdel-Wareth AU - Paul Thiessen AU - Gillian Lockitch Y1 - 2000/03/07 UR - http://www.cmaj.ca/content/162/5/647.abstract N2 - Background: Hypernatremic dehydration in neonates is a potentially devastating condition. Recent reports have identified breast-feeding malnutrition as a key factor in its pathophysiology. Methods: Using a theoretical framework for breast-feeding kinetics, a retrospective chart review of all neonates less than 28 days of age who were seen at either British Columbia's Children's Hospital or the Vancouver Breastfeeding Centre between 1991-1994 was conducted to identify and classify possible causes of breast-feeding malnutrition among neonates who developed hypernatremic dehydration. Results: Twenty-one cases hypernatremic dehydration were identified. Infant weight loss ranged from 8% to 30% of birth weight, and serum sodium levels ranged from 146 mmol/L to 207 mmol/L. In each case, maternal or infant factors (e.g., poor breast-feeding technique, lactation failure following postpartum hemorrhage and infant suckling disorders associated with cleft palate or ankyloglossia) that could interfere with either lactation or breast-feeding dynamics and account for insufficient breast milk intake were identified. Interpretation: Prenatal and in-hospital screening for maternal and infant risk factors for breast-feeding malnutrition combined with early postpartum follow-up to detect excessive infant weight loss are important for the prevention of neonatal hypernatremic dehydration. ER -