Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn
Hypernatremic dehydration in term newborns has steadily increased in incidence with increasing efforts to promote exclusive breastfeeding before hospital discharge, a key metric of the Baby-Friendly Hospital Initiative. The following report details a case of a term newborn infant who had evidence of...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/9/1379 |
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| author | Christie del Castillo-Hegyi Jennifer Achilles B. Jody Segrave-Daly Lynnette Hafken |
| author_facet | Christie del Castillo-Hegyi Jennifer Achilles B. Jody Segrave-Daly Lynnette Hafken |
| author_sort | Christie del Castillo-Hegyi |
| collection | DOAJ |
| description | Hypernatremic dehydration in term newborns has steadily increased in incidence with increasing efforts to promote exclusive breastfeeding before hospital discharge, a key metric of the Baby-Friendly Hospital Initiative. The following report details a case of a term newborn infant who had evidence of poor intake while exclusively breastfeeding during his hospital stay that may not have been recognized by health care providers. The infant was discharged home and was subsequently found by the parents in cardiac arrest 12 h after discharge and was found to have hypernatremic dehydration. Although return of spontaneous circulation was achieved after fluid resuscitation, the infant sustained extensive hypoxic-ischemic brain injury due to cardiovascular collapse. Due to the infant’s extremely poor prognosis, life support was withdrawn at 19 days of age and the infant expired. This sentinel case demonstrates multiple pitfalls of current perceptions of normal vs. abnormal newborn feeding behavior, weight loss percentages, elimination patterns, and acceptable clinical thresholds believed to be safe for neonates. Newer data have shown that hypernatremia occurs commonly in healthy, term breastfed newborns at weight loss percentages previously deemed normal by most health professionals and hospital protocols. In-hospital strategies to prevent excessive weight loss and screening for hypernatremia in response to signs of inadequate feeding have the potential to prevent tens of thousands of readmissions for feeding complications a year, as well as hundreds of millions in health care costs. |
| first_indexed | 2024-03-10T00:23:53Z |
| format | Article |
| id | doaj.art-855f4ffdb4fa43869571544c601d2602 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T00:23:53Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-855f4ffdb4fa43869571544c601d26022023-11-23T15:38:06ZengMDPI AGChildren2227-90672022-09-0199137910.3390/children9091379Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed NewbornChristie del Castillo-Hegyi0Jennifer Achilles1B. Jody Segrave-Daly2Lynnette Hafken3Department of Emergency Medicine, CHI St. Vincent, Little Rock, AR 72205, USAFed is Best Foundation, Little Rock, AR 72223, USAFed is Best Foundation, Little Rock, AR 72223, USAFed is Best Foundation, Little Rock, AR 72223, USAHypernatremic dehydration in term newborns has steadily increased in incidence with increasing efforts to promote exclusive breastfeeding before hospital discharge, a key metric of the Baby-Friendly Hospital Initiative. The following report details a case of a term newborn infant who had evidence of poor intake while exclusively breastfeeding during his hospital stay that may not have been recognized by health care providers. The infant was discharged home and was subsequently found by the parents in cardiac arrest 12 h after discharge and was found to have hypernatremic dehydration. Although return of spontaneous circulation was achieved after fluid resuscitation, the infant sustained extensive hypoxic-ischemic brain injury due to cardiovascular collapse. Due to the infant’s extremely poor prognosis, life support was withdrawn at 19 days of age and the infant expired. This sentinel case demonstrates multiple pitfalls of current perceptions of normal vs. abnormal newborn feeding behavior, weight loss percentages, elimination patterns, and acceptable clinical thresholds believed to be safe for neonates. Newer data have shown that hypernatremia occurs commonly in healthy, term breastfed newborns at weight loss percentages previously deemed normal by most health professionals and hospital protocols. In-hospital strategies to prevent excessive weight loss and screening for hypernatremia in response to signs of inadequate feeding have the potential to prevent tens of thousands of readmissions for feeding complications a year, as well as hundreds of millions in health care costs.https://www.mdpi.com/2227-9067/9/9/1379neonatal hypernatremic dehydrationneonatal dehydrationexclusive breastfeedingneonatal brain injurydevelopmental disabilityBaby-Friendly Hospital Initiative |
| spellingShingle | Christie del Castillo-Hegyi Jennifer Achilles B. Jody Segrave-Daly Lynnette Hafken Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn Children neonatal hypernatremic dehydration neonatal dehydration exclusive breastfeeding neonatal brain injury developmental disability Baby-Friendly Hospital Initiative |
| title | Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn |
| title_full | Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn |
| title_fullStr | Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn |
| title_full_unstemmed | Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn |
| title_short | Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn |
| title_sort | fatal hypernatremic dehydration in a term exclusively breastfed newborn |
| topic | neonatal hypernatremic dehydration neonatal dehydration exclusive breastfeeding neonatal brain injury developmental disability Baby-Friendly Hospital Initiative |
| url | https://www.mdpi.com/2227-9067/9/9/1379 |
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