Severe hypernatremic dehydration in a breastfed infant

Objective - To report a rare case of hypernatremic dehydration in an exclusively breastfed infant. Case report - We present a term newborn, 14-day-old boy, exclusively breastfed, who was lethargic and severely dehydrated upon admission (35% birth weight loss). The newborn was found to have severe hypernatremic dehydration (Na+ 197 mmol/l), acute renal insufficiency (Creatinine 273 umol/l) and metabolic acidosis. Also, the blood culture result was positive. Intravenous rehydration and antibiotic therapy were started. After 22 days of hospitalization, the infant was discharged home in a good general condition. Now the child is 13 months old, he is healthy and no neurologic sequelae are noticed. Conclusion - Hypernatremic dehydration in newborns is a rare complication, which is dangerous, but also preventable. Prevention consists in educating mothers about successful breastfeeding techniques, and also early newborn reassessment after discharge from the hospital is mandatory.