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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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Autores principales: del Castillo-Hegyi, Christie, Achilles, Jennifer, Segrave-Daly, B. Jody, Hafken, Lynnette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498092/
https://www.ncbi.nlm.nih.gov/pubmed/36138688
http://dx.doi.org/10.3390/children9091379
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author del Castillo-Hegyi, Christie
Achilles, Jennifer
Segrave-Daly, B. Jody
Hafken, Lynnette
author_facet del Castillo-Hegyi, Christie
Achilles, Jennifer
Segrave-Daly, B. Jody
Hafken, Lynnette
author_sort del Castillo-Hegyi, Christie
collection PubMed
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 Due to the infant’s extremely poor prognosis, life support was withdrawn at 19 days of age and the infant expired.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.
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spelling pubmed-94980922022-09-23 Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn del Castillo-Hegyi, Christie Achilles, Jennifer Segrave-Daly, B. Jody Hafken, Lynnette Children (Basel) Case Report 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. MDPI 2022-09-13 /pmc/articles/PMC9498092/ /pubmed/36138688 http://dx.doi.org/10.3390/children9091379 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
del Castillo-Hegyi, Christie
Achilles, Jennifer
Segrave-Daly, B. Jody
Hafken, Lynnette
Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498092/
https://www.ncbi.nlm.nih.gov/pubmed/36138688
http://dx.doi.org/10.3390/children9091379
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