Hypernatremic dehydration in term neonates in neonatal period

Dr Suresh Goyal; Dr Sunny Malvia; Dr Rajendra Chandel; Dr Lakhan Poswal; Dr Kavita Tiwari; Dr Lalit Mohan Sharma

Volume : VI, Issue : VII, July - 2017

Hypernatremic dehydration in term neonates in neonatal period

Dr Suresh Goyal, Dr Sunny Malvia, Dr Rajendra Chandel, Dr Lakhan Poswal, Dr Kavita Tiwari, Dr Lalit Mohan Sharma

Abstract :

Objective: To assess the problem of hypernatremic dehydration in healthy exclusively eastfed term neonates in neonatal period.

Methods: Hospital based prospective study on neonates (≥37 week gestation and >2kg birth weight) admitted with dehydration (>10% weight loss after birth and signs/symptoms of dehydration) and had hypernatremia (serum sodium >145 mEq/L at admission) in the NICU of Balchikitsalaya, MBGH, RNT Medical college, Udaipur, Rajasthan, India over a period of 12 months from July 2015 to June 2016. Sick neonates with sepsis, birth asphyxia and congenital anomalies were excluded. Informed consent was taken. Ethical clearance for the study was taken.

Results: A total of 218 neonates with hypernatremic dehydration were enrolled. Most of the neonates 188 (86.23%) with dehydration were admitted between Day 3 to 7 after birth. Mean weight loss % after birth in neonates with hypernatremic dehydration was 15.08%. Most neonates presented with excessive cry 161(73.8%), fever 151(69.3%) and jaundice 122(55.9%). Mean (SD) Sodium levels in these hypernatremic neonates was 161.44 (7.95) mEq/L.

23(10.55%) neonates had hyperkalemia. All 218 (100%) babies had high blood urea levels and 178(81.6%) had high creatinine levels. All 218(100%) neonates were hyperosmolar and had metabolic acidosis at admission. 216 babies were successfully discharged and 2 babies expired during hospital stay.

Conclusion: Hypernatremic dehydration in healthy term neonates is often seen. Hypernatremic dehydration should be suspected in all the neonates with some problem in east feeding (improper positioning, poor attachment, absent let down reflex, fissured/retracted nipples etc) to prevent neonates from its fatal complications.