ABSTRACT
Introduction: Hypernatremic dehydration in neonates is themost dangerous form of dehydration due to complicationsassociated with it as well as its management. This study wasplanned to study the impact of the significant physiologicchanges in body water content on serum sodium concentrationin the immediate postnatal period and try to identify riskfactors for hypernatremic dehydration.Material and Methods: Only healthy term/near-term babieswere included. They were examined on day four of life in thewell baby clinic. These neonates were again examined on daysseven and ten of life. Blood samples were collected on daysfour and ten of life, serum was separated and stored at -20°C.These serum samples were processed subsequently and serumsodium and potassium were estimated and compared withweight lost by the neonates.Results: 184 neonates were included in the study. Mean serumsodium level was 149 ± 6.0 mEq/l (range 135-172 mEq/l).Hypernatremia of varying severity was detected in 137neonates. By day 10 of life sodium levels had normalized inall hypernatremic neonates except one, who was hospitalizedon day 5 of life with hypernatremic dehydration. Perceptionof decreased milk production by mother, higher birth order,delivery by cesarean section and decreased urination in theneonate bore significant association with hypernatremia. Signsof dehydration were clinically discernible in nine patients andall of them had hypernatremia, however, most of the babiesdidn’t have obvious dehydration signs and weight loss wascomparable between two groups.Conclusion: Mild to moderate degree of hypernatremia isquite common during physiological dehydration in earlyneonatal period and adequate breastfeeding appears to bean effective and safe intervention for mild to moderatehypernatremic dehydration.