Dehydration

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The research below covers hypernatraemic dehydration.

Severe neonatal hypernatraemia: a population based study

This research shows that if mothers do not get adequate support to establish breastfeeding properly, then complications can sometimes arise such as dehydration, which can lead to severe hypernatraemia. Read the Baby Friendly Initiative’s full analysis of this study.

Oddie, S, et al (2012). Severe neonatal hypernatraemia: a population based study. ADC Fetal and Neonatal, doi:10.1136/archdischild-2012-302908.

Hydration status of near-term neonate babies

This Indian study into the hydration status of near-term neonates in the first week of life found that babies who were exclusively breastfed had a similar hydration status to those who received additional supplementary feeds.

Kusuma S, Agrawal SK,Kumar P et al (2009) Hydration Status of Exclusively and Partially Breastfed Near-Term Newborns in the First Week of Life. J Hum Lact  doi:10.1177/0890334408324453

Impact of early weighing policy on neonatal hypernatraemic dehydration and breastfeeding

This study found that introducing an early weighing policy (72-96 hours) resulted in an earlier recognition of difficulties, a lower percentage weight loss, smaller increase in sodium and higher breastfeeding rate at discharge and at eight weeks.

Iyer NP et al. (2008) Impact of an early weighing policy on neonatal hypernatraemic dehydration and breast feeding. Arch. Dis. Child; 93: 297-299

Screening for hypernatraemic dehydration

These two authors compared two methods of screening for hypernatraemic dehydration: a specific chart to plot weight during the first week of life, and a traditional “rule of thumb” of no more than 10% weight loss. Readmission to hospital with this condition is associated with poor breastfeeding management which with better early support and assessment could have been avoided and the fact that many mothers would cease to breastfeed following admission.

Both authors acknowledged that weighing alone is unlikely to prevent the problem and that assessment of the wellbeing of the baby and the breastfeeding is paramount. This should include urine output, frequency and quality of stools and observation for lethargy or fractious behaviour. This should be monitored together with an effective assessment of the breastfeeding including feeding pattern, effectiveness of attachment and sucking pattern and breast fullness.

Modi N (2007) Avoiding hypernatraemic dehydration in healthy term infants. Archives of Disease in Childhood; 92: 474-5

Van Dommelen et al (2007) reference chart for relative weight change to detect hypernatraemic dehydration. Archives of Disease in Childhood; 92: 490-494-5