Journal Information
Vol. 61. Issue 4.
Pages 340-343 (1 October 2004)
Share
Share
Download PDF
More article options
Vol. 61. Issue 4.
Pages 340-343 (1 October 2004)
Full text access
Deshidratación hipernatrémica asociada a lactancia materna
Hypernatremic dehydration associated with breast-feeding
Visits
28832
O. Peñalver Giner
Corresponding author
tomas_mig@gva.es

Correspondencia: Servicio de Pediatría. Hospital Francesc de Borja de Gandía. P.° Germanies, 71. 46700 Gandía. Valencia. España.
, J. Gisbert Mestre, J. Casero Soriano, A. Bernal Ferrer, M. Oltra Benavent, M. Tomás Vila
Servicio de Pediatría. Hospital Francesc de Borja de Gandía. Valencia. España
This item has received
Article information
Antecedentes

En los últimos 10 años ha habido un incremento de publicaciones que alertan sobre un aumento en la incidencia de la hipernatremia en niños alimentados con lactancia materna exclusiva

Objetivo

Presentar los resultados de una serie de casos detectados en un hospital de área en los últimos 6 años, para ayudar a conocer mejor el perfil clínico de este proceso, su tratamiento idóneo y las medidas preventivas

Material y Método

Se ha definido como caso todo aquel niño de menos de 30 días, con sodio en sangre mayor o igual de 150 mEq/ml y con lactancia materna exclusiva. Se ha realizado la búsqueda de casos en la base de datos de nuestro servicio

Resultados

Se han encontrado 12 niños que cumplían criterios, presentando las siguientes características: edad gestacional media de 39,5 semanas; peso medio al nacimiento, 3.440 g; porcentaje de peso medio perdido, 13,7 %, y valor de sodio medio, 152,75 mEq/ml. Cinco de los neonatos (42 %) ingresaron procedentes de nuestra maternidad y 7 (58 %) desde urgencias. Los motivos de consulta fueron: pérdida de peso (9 casos), irritabilidad (6 casos), fiebre (6 casos), rechazo de la alimentación (5 casos) e ictericia (2 casos); presentando la mayoría más de una causa de consulta. En cuanto a las madres, el 83,33 % (10 de ellas) fueron primíparas, y el 16,67 % (2 casos) secundíparas

Conclusiones

La hipernatremia asociada a lactancia materna es un proceso relacionado con una mala técnica de lactancia en madres inexpertas. Las soluciones hay que buscarlas en un mayor apoyo a la madre lactante por parte de los profesionales sanitarios

Palabras clave:
Lactancia materna
Hipernatremia
Deshidratación
Background

During the last 10 years the number of publications reporting a rise in the incidence of hypernatremia in children who are exclusively breast-fed has increased

Objective

To report the results of a series of cases detected in a district hospital in the last 6 years in order to better delineate the clinical characteristics of infant hypernatremia, its optimal treatment and preventive measures

Material and Method

The selection criteria for our study included all neonates aged less than 30 days with serum sodium concentrations equal to or greater than 150 mEq/mL who were exclusively breast fed. Cases were identified through the departmental database

Results

Twelve newborns were identified who presented the following characteristics: mean gestational age of 39.5 weeks, mean birth weight of 3440 grams, mean percentage of weight loss from birth 13.7 % and mean serum sodium value 152.75 mEg/mL. Five neonates (42 %) were admitted from the maternity unit and seven (58 %) from the emergency department. The presenting complaints included weight loss in nine infants, irritability in six, fever in six, poor feeding in five and jaundice in two. Most of the neonates had more than one symptom. Ten of the mothers (83.33 %) were primiparous and two (16.67 %) were secundiparous

Conclusions

Hypernatremia due to breast-feeding is a consequence of inadequate breast-feeding technique in inexperienced mothers. A possible solution would be for health professionals to provide mothers with greater support

Keywords:
Breast-feeding
Hypernatremia
Dehydration
Full text is only aviable in PDF
Bibliografía
[1.]
I.A. Laing, C.M. Wong.
Hypernatremia in the first few days: is the incidence rising?.
Arch Dis Child Fetal Neonatal, 87 (2002), pp. F158-F162
[2.]
A. Bajpai.
Hypernatremic dehydration in a neonate.
Indian Pediatr, 39 (2002), pp. 599-600
[3.]
S. Oddie, S. Richmond, M. Coulthard.
Hypernatraemic dehydration and breastfeeding: A population study.
Arch Dis Child, 85 (2001), pp. 318-320
[4.]
D. Harding, P. Cairns, S. Gupta, F. Cowan.
Hypernatraemia: why bother weighing breast fed babies?.
Arch Dis Child Fetal Neonatal Ed, 85 (2001), pp. f145
[5.]
V.H. Livingstone, C.E. Willis, L.O. Abdel-Wareth, P. Thiessen, G. Lockitch.
Neonatal hypernatremia dehydration associated with breast-feeding malnutrition: A retrospective survey.
Cmaj, 162 (2000), pp. 647-652
[6.]
W.O. Cooper, H.D. Atherton, M. Kahana, U.R. Kotagal.
Increased incidence of severe breastfeeding malnutrition and hypernatremia in a metropolitan area.
Pediatrics, 96 (1995), pp. 957-960
[7.]
J. González de Dios, M. Moya Benavent, M.J. Mateo Moraleda.
Malnutrición y deshidratación hipernatrémica neonatal severa por lactancia materna.
Rev Esp Pediatr, 54 (1998), pp. 83-86
[8.]
R. Mangaro, C. Mami, T. Marrone, L. Marseglia.
Incidence of dehydration and hypernatremia in exclusively breast-fed infants.
J Pediatr, 139 (2001), pp. 673-675
[9.]
T.A. Clarke, M. Makarian, W. Griswold, et al.
Hypernatremic dehydration resulting from inadequate breast-feeding.
Pediatrics, 63 (1979), pp. 931-932
[10.]
T.W. Rowland, R.T. Zori, W.R. Lafleur, et al.
Malnutrition and hypernatremic dehydration in breast-fed infants.
Jama, 247 (1982), pp. 1016-1017
[11.]
J.D. Thullen.
Management of hypernatremic dehydration due to insufficient lactation.
Clin Pediatr, 27 (1988), pp. 370-372
[12.]
K.M. Jaffe, M.J. Kraemer, M.C. Robinson.
Hypernatremia in breast- fed newborns.
West J Med, 135 (1981), pp. 54-55
[13.]
O.F. Roddey Jr., E.S. Martin, R.L. Swetenburg.
Critical weight loss and malnutrition in breast-fed infants.
Am J Dis Children, 135 (1981), pp. 597-599
[14.]
R. Marino, S. Gourji, W. Rosenfeld.
Neonatal metabolic casebook. Hypernatremia and breast feeding.
J Perinatol, 9 (1989), pp. 451-453
[15.]
S.K. Anand, C. Sanborg, R.G. Robinson, et al.
Neonatal hypernatremia associated with elevated sodium concentration of breast milk.
J Pediatr, 96 (1980), pp. 66-68
[16.]
J.M Peters.
Hipernatremia in breast-fed infants due to elevated breast milk sodium.
J Am Osteopath Assoc, 89 (1989), pp. 1165-1170
[17.]
N. Kini, S. Zahn, S.L. Werlin.
Hypernatremic dehydration in breast- fed infants.
Wis Med J, 94 (1995), pp. 143-145
[18.]
Lactancia materna.
Manual para profesionales,
[19.]
L.A. Chilton.
Prevention and management of hypernatremic dehydration in breast-fed infants.
West J Med, 163 (1995), pp. 74-76
[20.]
A.S. Ryan, Z. Wenjun, A. Acosta.
Breastfeeding continues to increase into the new milleninium.
Pediatrics, 110 (2002), pp. 1103-1109
[21.]
J. Romero Sánchez, J. Romero González, B. Picazo Angelín, L. Tapia Ceballos, R. Díaz Cabrera, I. Romero Sánchez.
Alta hospitalaria temprana en recien nacidos a término sanos.
An Esp Pediatr, 50 (1999), pp. 479-484
[22.]
R.H. Van Amerogen, A.C. Moretta, T.J. Gaeta.
Severe hypernatremic dehydration and death in breast-fed infant.
Pediatr Emerg Care, 17 (2001), pp. 175-180
[23.]
J.A. Kaplan, R.W. Siegler, G.A. Schmunk.
Fatal hypernatremic dehydration in exclusively breast-fed newborn infants due to maternal lactation failure.
Am J Forensic Med Pathol, 19 (1998), pp. 19-22
[24.]
J.R. Kennedy.
Offer infants water.
Pediatrics, 105 (2000), pp. 686
Copyright © 2004. Asociación Española de Pediatría
Download PDF
Idiomas
Anales de Pediatría (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?