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Pediatría Atención Primaria

Print version ISSN 1139-7632


LOPEZ MARTIN, David et al. Severe neonatal hypernatremic dehydratation in the initiation of the breastfeeding: study of incidence and associated factors. Rev Pediatr Aten Primaria [online]. 2018, vol.20, n.79, pp.229-235. ISSN 1139-7632.


neonatal hypernatremic dehydration associated with failure in the establishment of breastfeeding instauration can cause significant complications and even death. There are few studies on its incidence in Spain. Objectives: our aim was to determine the incidence of this problem and describe the epidemiological and clinical features associated with it.

Materials and methods:

we conducted a retrospective observational study in newborns with a diagnosis of hypernatremic dehydration and serum sodium levels of less than 150 mEq/l that required hospitalization between 2011 and 2017 in our catchment area. We excluded patients with underlying conditions or concomitant infection. We collected data on epidemiological, clinical, laboratory, treatment and outcome variables through the review of health records, followed by their statistical analysis.


the estimated size of the susceptible population was 41 084 newborns. Twenty met the inclusion criteria. In this sample, 19/20 newborns were exclusively breastfed, 14/20 were the first-born child, and the median maternal age was 34 years (interquartile range: 31-37). The most frequent reasons for seeking care were weight loss, jaundice and irritability. The median age at admission was 5.5 days (interquartile range: 3.3-9.8), the percentage of birth weight lost was 14.4% (interquartile range: 10-17), and the median serum sodium level was 157.25 mEq/l (interquartile range: 152-157.8). The mean length of stay was 6.5 days (interquartile range: 4-8.75), and 2/20 newborns required intensive care. None of the patients died or had severe complications.


we found an overall incidence of hypernatremic dehydration of 0.5 per 1000 live births per year in the population under study. We found an association with exclusive breastfeeding, primiparity and greater maternal age. In light of these results, it seems advisable to provide information on the warning signs at the time of discharge from the maternity ward, and to schedule the first checkup for the baby at an earlier time.

Keywords : Breast feeding; Infant, newborn; Dehydration; Hypernatremia.

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