Hypernatraemic Dehydration in a Newborn

Abstract

Introduction: The World Health Organization recommends initiating breastfeeding within the first hour of birth and exclusively breastfeeding for the first six months. This practice reduces the risk of infant illnesses such as diarrhoea and pneumonia and benefits mothers by lowering the risk of postpartum haemorrhage and certain cancers. Successful breastfeeding depends on factors like milk production, effective infant latch, maternal mental health, and support systems. Difficulties with breastfeeding can lead to serious neonatal complications, including hypernatraemic dehydration, defined as a serum sodium level above 145 mEq/L.
Case Report: We present a case of a 10-day-old male neonate, born at term by caesarean section after an uneventful pregnancy except for third trimester oligohydramnios. Despite initial breastfeeding attempts, the infant developed significant weight loss, reduced bowel movements, and decreased urine output by the tenth day of life. Upon admission, he had lost 26% of his birth weight, appeared cachectic, and exhibited signs of severe dehydration. Laboratory tests confirmed hypernatraemia (serum sodium concentration of 156 mEq/L). Immediate treatment with formula feeding and intravenous fluids resulted in normalization of serum sodium levels within 18 hours, and the infant regained his birth weight by day 17 of life.
Discussion: Hypernatraemia in neonates, particularly when related to breastfeeding difficulties, is a critical condition that can cause severe neurological and systemic complications. The rising incidence of hypernatraemia associated with exclusive breastfeeding underscores the need for adequate lactation support and close monitoring. Early hospital discharge without proper breastfeeding counselling significantly increases this risk.
Conclusion: While breastfeeding promotion is vital for public health, ensuring adequate support and monitoring is essential to prevent complications such as hypernatraemic dehydration. Close follow-up, regular weight monitoring, and access to professional lactation support are crucial for safeguarding the health of both infants and mothers.