September 9, 2005

Breastfed Babies Can Become Dehydrated

NEW YORK -- When breastfeeding is not properly established, the baby may become dehydrated and levels of sodium in its blood can become excessive, according to a study published this week. The condition is relatively common but can be difficult to recognize.

In the journal Pediatrics, clinicians explain that so-called "hypernatremic dehydration" in newborns arises from the inadequate transfer of breast milk from mother to infant. Poor milk drainage from the breasts leading to persistently high sodium concentrations in milk may worsen sodium levels in the infant.

According to Dr. Michael L. Moritz of Children's Hospital of Pittsburgh, "New mothers, especially first-time mothers, may have difficulty producing an adequate supply of breast milk in the first week after birth because of physiological issues or because the baby may not be able to latch on properly."

Pediatricians and parents need to be aware that when this occurs, the risk of dehydration is much higher than previously assumed, he continued.

"If infants are becoming dehydrated, we strongly recommend that the breast milk be supplemented with formula or breast milk from another source," Moritz said.

He and his colleagues found that among 3718 breastfed newborns hospitalized during a 5-year period, 70 had breastfeeding-associated hypernatremic dehydration. This rate is much higher than seen in older children and other patients admitted to hospital.

It's likely that as more women initiate breastfeeding in response to strong encouragement by the American Academy of Pediatrics, the "incidence of breastfeeding-associated hypernatremia will increase and that currently the condition is under-recognized," the team notes.

SOURCE: Pediatrics, September 2005.