Life-Threatening Hypernatremic Dehydration in a 7-Week-Old Exclusively Breastfed Infant as a Cause of a Decline in Breastmilk Volume and Parental Language Barriers in a North African Family

Abstract

Breast-feeding is regarded as the most appropriate source of nutrition for healthy, full-term newborns and infants. Here, we present the case of a full-term, seven week old male infant who was exclusively breast-fed but who developed severe hypernatremic dehydration as a result of declined breast milk volume that was not recognized by the parents. In order to prevent serious therapy-associated side effects due to rapid rehydration, we performed a rehydration regime providing a slow decrease of serum sodium levels by carefully infusing hypertonic saline solution. Following this approach, the patient could be discharged without any noticeable disorder. As the incidence of breast-feeding associated hypernatremic dehydration in the developed countries is increasing, strategies of prevention are discussed.

Zusammenfassung

Die Vorteile der Muttermilchernährung für die bedarfsgerechte Ernährung gesunder Neugeborener sind allgemein akzeptiert. Wir präsentieren den Fall eines reifen, 7 Wochen alten, voll gestillten Säuglings, der infolge abnehmender Mengen an Muttermilch unbemerkt eine schwere hypertone Dehydratation entwickelte. Um einem schnellen Abfall des Serumnatriums entgegen zu wirken, wurde mit der Infusion hypertoner Kochsalzlösung einem strikten Rehydratationsregime gefolgt. Parallel wurde mit dem enteralen Nahrungsaufbau begonnen. Der Patient konnte ohne Residuen nach Hause entlassen werden. Aufgrund der zunehmenden Inzidenz von mit dem Stillen assoziierten Zuständen hypertoner Dehydratation in den entwickelten Ländern werden Möglichkeiten der Prävention diskutiert.

Key words

hypernatremic dehydration - lactation failure - breast-feeding - prevention

Hypertone Dehydratation - Stillprobleme - Stillen - Prävention

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