Prevalence of Breastfeeding–associated Hypernatremia among Hospitalized Hyperbilirubinemic Neonates

Introduction: This study aimed to assess the incidence of breastfeeding-associated hypernatremia and related risk factors among hospitalized hyperbilirubinemic neonates. Methods: This prospective study was conducted at Nemazee Hospital affiliated to Shiraz University of Medical Sciences during one year to determine the association between hypernatremia (serum sodium concentration of >150 mEq/L) and exclusive breastfeeding of the neonates. During the study period, 122 neonates were recruited and the patients’ history was taken through using the medical records (regarding child delivery) and asking the mother. Laboratory data including total and direct bilirubin levels, serum sodium level and blood urea nitrogen (BUN) were recorded. P-valueResults: The study was carried out on 86 exclusively breastfed neonates (EBFN) and 36 neonates with mixed type of feeding. The incidence of hypernatremia among the EBFN and non-exclusively breastfed neonates (non-EBFN) was 9.3% and 2.7%, respectively. Moreover, 55% of the neonates with hypernatremia had a significant weight loss (>10% cummulative weight loss). A significant correlation was observed between hypernatremia and weight loss (P=0.008). Also, in spring and autumn, no hypernatremia was observed among 53 cases, and during summer and winter, 9 out of 69 neonates (13%) presented with hypernatremia (P=0.042). Conclusion: Hypernatremic dehydration is relatively common among EBFN. Regular weight monitoring, proper breastfeeding and environmental temperature control should be encouraged for preventing breastfeeding-associated hypernatremia.