Hypernatremia and excessive weight loss in exclusively breastfed term infants in early neonatal period

Abstract

Introduction: Newborn infants lose weight in the first week of life. There is an increasing recognition of hypernatremia and it’s complications in exclusively breastfed newborns. Early recognition of critical weight loss, signs, and symptoms of dehydration and hypernatremia are keys to prevent morbidity and mortality in these neonates. Objectives: To identify term neonates with excessive weight loss >10% of birth weight and to compare their serum sodium levels with levels in babies with weight loss <10% of birth weight. Materials and Methods: A prospective observational study was conducted on healthy full-term exclusively breastfed newborns delivered in a rural tertiary hospital. The primary outcome was the proportion of newborn infants with loss >10% of birth weight at day 5 and serum sodium levels in these babies. Results: Weight loss >10% of the birth weight was seen in 6.22% of term babies. The mean weight loss in this group was 360.14±81.82 g in comparison to 141.32±67.78 g in rest of the babies. Serum sodium >149 meq/L was seen in three neonates in excess weight loss group, i.e., 1.33% of neonates in the study. The mean serum sodium was higher in babies with excess weight loss (141.71±4.39 vs. 139.74±2.32 mEq/L, p=0.0045). Conclusion: About 6.22% of exclusively breastfed term neonates had excessive weight loss and serum sodium levels were higher in these babies with than those with weight loss <10% of birth weight. Neonates with excessive weight loss need more cautious follow-up for early recognition of potential hypernatremia and its complications.