Neonatal Hypernatremic Dehydration Secondary to Lactation Failure

Scott E. Rand, MD, University of Texas Medical Branch, Conroe; Amy Kolberg, MD, Department of Obstetrics and Gynecology, University of Missouri, Kansas City.

J Am Board Fam Med. 2001;14(2) 

In This Article

Introduction

Dehydration in the neonatal period has many causes. Dehydration is classified as isotonic, hypotonic, or hypertonic, based on the serum osmolality that in most cases is reflected in the serum sodium level. Hypernatremic dehydration is usually caused by gastroenteritis, but it can also be caused by salt poisoning or diabetes insipidus. This type of dehydration can be especially dangerous. The hyperosmolar state can lead to brain shrinkage, venous thrombosis, and subdural capillary hemorrhage. In addition, rehydration can cause cerebral edema and subsequent seizures. Seizures can frequently occur, even with the best rehydration regimens. Breast-feeding can commonly cause mild dehydration, but it is usually quite well tolerated. No prospective studies have been done to investigate the incidence or prevalence of hypernatremic dehydration secondary to lactation failure. At least one author believes that the condition is more common now because of early infant hospital discharge without adequate follow-up.[1] We report a case report and literature review of hypernatremic dehydration caused by lactation failure.

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