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Hypernatremic dehydration - a case series



Hypernatremic dehydration manifests
typically in neonates in the first 2 weeks
of life. The common risk factors for it include
primi-parity, anxious elderly mother
with lactation problems, caesarean delivery
and early discharge. Most of these
babies are seen during the summer
months. The common presenting features
include excessive weight loss, hyperthermia,
jaundice, lethargy and poor
feeding. We present herewith the clinical
characteristics and the challenges we
encountered in managing 27 babies with
Hypernatremic dehydration.

Full Text:



Laing IA, Wong CM. Hypernatraemia

in the first few days: is the incidence

rising? Arch Dis Child Fetal Neonatal

Ed. 2002 Nov;87(3):F158-62

Neifert MR. Prevention of breastfeeding

tragedies. Pediatr Clin North

Am 2001;48:273–97

Moritz ML, Manole MD, Bogen DL,

Ayus JC. Breastfeeding-associated

hypernatremia: are we missing the diagnosis?

Pediatrics. 2005 Sep;116


Bhat SR, Lewis P, David A, Liza SM.

Dehydration and hypernatremia in

breast-fed term healthy neonates. Indian

J Pediatr. 2006 Jan;73(1):39-41

Allen JC, Keller RP, Archer P,

Neville MC. Studies in human lactation:

milk composition and daily secretion

rates of macronutrients in the first

year of lactation. Am J Clin Nutr. 1991


Verbalis JG. Brain volume regulation

in response to changes in osmolality.

Neuroscience. 2010 Jul 28;168(4):862-

Loyher ML, Mutin M, Woo SK, Kwon

HM, Tappaz ML (2004) Transcription

factor tonicity-responsive enhancerbinding

protein (TonEBP) which transactivates

osmoprotective genes is expressed

and upregulated following

acute systemic hypertonicity in neurons

in brain. Neuroscience 124:89–

Oddie SJ, Craven V, Deakin K,

Westman J, Scally A. Severe neonatal

hypernatraemia: a population based

study. Arch Dis Child Fetal Neonatal

Ed. 2013 Sep;98(5):F384-7

Bolat F, Oflaz MB, Güven AS, Özdemir

G, Alaygut D, Doan MT, Içaasolu

FD, Cevit Ö, GültekinA. What is the

safe approach for neonatal hypernatremic

dehydration? A retrospective study

from a neonatal intensive care unit. Pediatr

Emerg Care. 2013 Jul;29(7):808-

Palevsky PM (1998) Hypernatremia.

Semin Nephrol 18:20–30

Alshayeb HM, Showkat A, Babar F,

Mangold T, Wall BM. Severe hypernatremia

correction rate and mortality in

hospitalized patients. Am J Med Sci.


Schwaderer AL, Schwartz GJ. Treating

hypernatremic dehydration. Pediatr

Rev. 2005 Apr;26(4):148-50

Greenbaum LA Deficit therapy. In:

Kleigman RM, Stanton BF, Schor NF, et

al, eds. Nelson textbook of pediatrics

th edition. Elsevier Saunders; 2011:

Jain S, Basu S. Hypernatremic dehydration

in term and near-term neonates.

Indian J Pediatr. 2010 Apr;77


Cheuvront SN, Kenefick RW, Sollanek

KJ, Ely BR, Sawka MN. Waterdeficit

equation: systematic analysis

and improvement. Am J Clin Nutr. 2013


Erdemir A, Kahramaner Z, Cosar H,

Turkoglu E, Kanik A, Sutcuoglu S, Ozer

EA. Comparison of oral and intravenous

fluid therapy in newborns with hypernatremic

dehydration. J Matern Fetal Neonatal

Med. 2014 Mar;27(5):491-4

Yildiz N, Erguven M, Yildiz M, Ozdogan

T, Turhan P. Acute peritoneal dialysis in

neonates with acute kidney injury and hypernatremic

dehydration. Perit Dial Int.


Zaki SA, Mondkar J, Shanbag P,

Verma R. Hypernatremic dehydration due

to lactation failure in an exclusively breastfed

neonate. Saudi J Kidney Dis Transpl.



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