Caglar M K, Ozer I, Altugan F S
Department of Pediatrics, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
Braz J Med Biol Res. 2006 Apr;39(4):539-44. doi: 10.1590/s0100-879x2006000400015. Epub 2006 Apr 3.
Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss > or = 10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05), primiparity (P < 0.005), less than four stools (P < 0.001), pink diaper (P < 0.001), delay at initiation of first breast giving (P < 0.01), birth by cesarean section (P < 0.05), extra heater usage (P < 0.005), extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001), mean weight loss in neonates with pink diaper (P < 0.05), mean uric acid concentration in neonates with pink diaper (P < 0.0001), fever in hypernatremic neonates (P < 0.02), and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02) were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.
前瞻性收集了出生时纯母乳喂养的健康足月儿以及无产科并发症的健康母亲的数据，以确定纯母乳喂养婴儿体重过度减轻和高钠血症的危险因素。2001年4月至2005年1月期间，诊断出34例体重减轻≥10%的新生儿。18例符合研究条件的婴儿中有6例发生高钠血症。确定了与母乳喂养困难相关的乳房状况（P<0.05）、初产（P<0.005）、排便少于4次（P<0.001）、尿布呈粉红色（P<0.001）、首次母乳喂养开始延迟（P<0.01）、剖宫产分娩（P<0.05）、使用额外加热器（P<0.005）、有与母乳喂养相关适当条件的母亲中使用额外加热器的情况（P<0.001）、尿布呈粉红色的新生儿的平均体重减轻（P<0.05）、尿布呈粉红色的新生儿的平均尿酸浓度（P<0.0001）、高钠血症新生儿的发热（P<0.02）以及体重减轻与血清钠和尿酸浓度的相关性（P<0.02）。纯母乳喂养的婴儿会出现体重过度减轻，并且可能并发高钠血症和其他疾病。分娩后立即开始母乳喂养，以及母乳喂养出现问题（特别是乳房衔接不良、乳房胀痛、母乳“下奶”延迟和乳头问题）时及时干预，将有助于促进母乳喂养成功。出院后对母乳喂养母婴进行仔细随访，尤其是关注婴儿体重，对于发现母乳喂养不足很重要。加热器等环境因素可能会加重婴儿脱水。
