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A Case of Hypernatremic Dehydration in an Exclusively Breast-Fed Newborn Infant

Journal of the Korean Pediatric Society 2002;45(6):790-795.
Published online June 15, 2002.
A Case of Hypernatremic Dehydration in an Exclusively Breast-Fed Newborn Infant
Kyung Pil Park1, Jin Kyung Kim2, Heng Mi Kim1
1Department of Pediatrics, College of Medicine, Kyungpook University, Taegu, Korea
2Department of Pediatrics, College of Medicine, The Catholic University of Korea, Taegu, Korea
모유수유 신생아에게 발생한 고나트륨혈성 탈수증 1례
박경필1, 김진경2, 김행미1
1경북대학교 의과대학 소아과학교실
2대구가톨릭대학교 의과대학 소아과학교실
Heng Mi Kim, Email: hmkim@knu.ac.kr
Sporadic reports of hypernatremic dehydration in breastfed newborn infants have appeared in medical literature for at least 3 decades. We report the first case of hypernatremic dehydration resulting from inadequate breast-feeding in Korea. A 14-day old baby, born to a mentally retarded mother, was transferred to our hospital with a body weight loss of 460 g since birth(17%) and a serum sodium(Na) level of 179 mEq/L, after initial hydration at another hospital. On admission, a cardiac murmur was heard and an enlarged liver was palpated. Cardiac ultrasonogram revealed ventricular septal defect and ostium secundum atrial septal defect. During hydration, a seizure-like attack developed. Serum Na decreased to 135 mEq/L on the 5th day of admission. Brain ultrasonography and brain magnetic resonance image revealed no remarkable abnormalities. Electroencephalography was normal. She suffered from prerenal azotemia, hyperglycemia and disseminated intravascular coagulation at admission but was treated successfully. Heart failure was also controlled with dobutamine, diuretics and digoxin.
Key Words: Hypernatremia, Dehydration, Breastfeeding, Newborn infant

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