Asymptomatic hypernatremia in exclusively breastfed neonates

ABSTRACT

Background: The aim of study was to identify the asymptomatic hyparnatremia in exclusively breastfed neonates and to study the factors associated with it.Methods: A cross-sectional study was conducted from November 2010 to October 2012 in Jawaharlal Nehru Medical College and Hospital, A. M. U., Aligarh. Consecutive term appropriate-for-gestational age and asymptomatic neonates who were exclusively breastfed since birth were enrolled.Results: A total of 1360 term neonates were screened, out of which 145 neonates in each early and late neonatal group were enrolled. Prevalence of hypernatremia in 290 patients was 4.48% (n=13) with mean serum sodium level of 156.6'5.5 mmol/L, ranging from 151 to 167 mmol/L. It was 16 times more common in early compare to late neonates (adjusted odds ratio=16.074, P=0.001), 6 times more common in primi mothers (adjusted odds ratio=6.037, P=0.010) and 7 times more common during summer season (May-August) (adjusted odds ratio=6.566, P=0.017). Other variables like sex, mode of delivery and blood urea levels do not show significant association with hypernatremia. There was a significant positive correlation of serum sodium level with blood urea (r=0.123, P=0.037) and serum creatinine levels (r=0.157, P=0.007), and a negative correlation with blood sugar levels, but it was not significant (r=-0.072, P=0.224).Conclusions: The prevalence of hypernatremia in exclusively breastfed term asymptomatic neonates is 4.8%, and is more common in early neonatal period, in summer season and in babies born to primi mothers. There was a significant positive correlation of serum sodium with blood urea and creatinine levels.