Increased Incidence of Severe Breastfeeding Malnutrition and Hypernatremia in a Metropolitan Area

[摘要] Objective : To identify common characteristics among infants with breastfeeding malnutrition in a region with an increasing incidence of breastfeeding malnutrition.Design . Retrospective case series.Setting . A 361-bed regional tertiary care children's hospital in a 1.7 million population metropolitan area.Patients . Case series: five infants with severe breast-feeding malnutrition and hypernatremia admitted to a tertiary care children's hospital over a 5-month period. Retrospective case review: 166 infants admitted between 1990 and 1994 with the diagnosis of dehydration, hypernatremia, or malnutrition.Main Outcome Measures . Maternal characteristics, age at presentation, percent loss from birth weight, serum sodium, average age at birth hospital discharge, neurologic, or cardiovascular complications.Results . Five infants were admitted to a children's hospital over a 5-month period with severe breastfeeding malnutrition and hypernatremia. The average weight loss at time of readmission was 23% (± 8%) from birth weight. The average presenting sodium was 186 ± 19 mmol/L. Three suffered significant complications. From 1990 through 1994, there was a statistically significant ( P < .05) annual increase in the number of infants admited with breastfeeding malnutrition and hypernatremia.Conclusions . While breastfeeding malnutrition and hypernatremia is not a new problem, this cluster of infants represents an increase in frequency and severity of the problem and could be a consequence of several factors, including inadequate parent education about breastfeeding problems and inadequate strategies for infant follow-up.

[学科分类] 儿科学