Boskabadi Hassan, Maamouri Gholamali, Ebrahimi Mansour, Ghayour-Mobarhan Majid, Esmaeily Habib, Sahebkar Amirhossein, Ferns Gordon A A
Ghaem Hospital, and Department of Biochemistry and Nutrition, Faculty of Medicine, Mashhad University of Medical Science (MUMS), Mashhad, Iran.
Asia Pac J Clin Nutr. 2010;19(3):301-7.
Neonatal hypernatermic dehydration (NHD) is a potentially very serious condition, which has been reported to occur in infants who have breast feeding problems in the first week of the life. This study looked at the incidence, risk factors, clinical symptoms and complications of NHD in healthy breastfed term neonates.
A prospective case-control study was conducted on 53 neonates with serum sodium concentrations of >or=150 mmol/L (as the case group) who were recruited between June 2006 and June 2007 from the Ghaem hospital (Mashhad, Iran) to investigate the relationship between NHD and breastfeeding. Fifty-three healthy breastfed full-term neonates (serum sodium<150 mmol/L) from the same hospital were also recruited as the control group.
The results showed an average weight loss of 1.6% in the healthy neonates vs. 16.2% in infants with NHD (p<0.001). The frequency of feeds received per day was 10.2 for the healthy neonates vs. 7.6 in the NHD group (p<0.001). The NHD group had mothers who had a higher frequency of breast problems (23 vs. 7, p<0.001). Mean serum sodium concentration was significantly lower in the control group compared with the cases (137.80 vs.160.06 mmol/L, p<0.001). The main presenting features of the infants with NHD were fever, lethargy and jaundice.
Breastfeeding problems are associated with the presence of NHD. Therefore, more breast examination during prenatal and postnatal periods and careful neonatal weight watch during the first week of life could decrease the incidence of NHD.
新生儿高钠性脱水（NHD）是一种潜在的非常严重的病症，据报道在出生后第一周存在母乳喂养问题的婴儿中出现。本研究观察了健康足月母乳喂养新生儿中NHD的发病率、危险因素、临床症状及并发症。
对2006年6月至2007年6月期间从伊朗马什哈德的加姆医院招募的53例血清钠浓度≥150 mmol/L的新生儿（作为病例组）进行前瞻性病例对照研究，以调查NHD与母乳喂养之间的关系。同时从同一家医院招募了53例健康的足月母乳喂养新生儿（血清钠<150 mmol/L）作为对照组。
结果显示，健康新生儿平均体重减轻1.6%，而NHD婴儿为16.2%（p<0.001）。健康新生儿每天的喂奶次数为10.2次，而NHD组为7.6次（p<0.001）。NHD组母亲的乳房问题发生率更高（23例对7例，p<0.001）。对照组的平均血清钠浓度显著低于病例组（137.80对160.06 mmol/L，p<0.001）。NHD婴儿的主要表现特征为发热、嗜睡和黄疸。
母乳喂养问题与NHD的发生有关。因此，产前和产后进行更多的乳房检查以及在出生后第一周仔细监测新生儿体重，可降低NHD的发病率。
