What causes hypernatremia in newborns?

Neonatal hypernatremia is a serious condition in the newborn period. We present infants with hypernatremic dehydration due to breast milk (BM) hypernatremia. Hypernatremic dehydration in breast-fed newborns is usually secondary to insufficient lactation.

What causes high sodium levels in newborn babies?

Excess sodium intake in newborns could be a result of an infusion of sodium bicarbonate or the improper preparation of formula or oral rehydration solution. Many case reports have attributed BFHD to high sodium content in breast milk; it also can be attributed to low breast milk production in a mother.

What is the most common cause for Hypernatremia?

The main cause of hypernatremia usually involves dehydration due to an impaired thirst mechanism or limited access to water, according to the Merck Manual. The disorder can also result from diarrhea or vomiting, taking diuretics or having a high fever.

What is infant Hypernatremia?

Hypernatremia is a serum sodium concentration > 150 mEq/L (> 150 mmol/L), usually caused by dehydration. Signs include lethargy and seizures. Treatment is cautious hydration with IV saline solution.

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What causes hypernatremia in children?

Hypernatremia is most often caused by the failure to replace water losses, which, in children, are most commonly due to gastrointestinal fluid loss. In these patients, the sodium plus potassium concentration in the fluid that is lost is less than the plasma sodium concentration.

How is Hypernatremia treated in newborns?

Hypernatremia is a serum sodium concentration > 150 mEq/L (> 150 mmol/L), usually caused by dehydration. Signs include lethargy and seizures. Treatment is cautious hydration with IV saline solution.

Can you tell if a newborn has brain damage?

Other early symptoms of brain damage can include seizures. An infant may also display certain behavioral symptoms of brain damage like excessive crying, unusual irritability or fussiness, difficulty sleeping or eating, and other signs of general discomfort that have no other explanation.

When should Hypernatremia be corrected?


Clinical recommendation Evidence rating References
Chronic hypernatremia should be corrected at a rate of 0.5 mEq per L per hour, with a maximum change of 8 to 10 mEq per L in a 24-hour period. C 33

How do you fix Hypernatremia?

In patients with hypernatremia of longer or unknown duration, reducing the sodium concentration more slowly is prudent. Patients should be given intravenous 5% dextrose for acute hypernatremia or half-normal saline (0.45% sodium chloride) for chronic hypernatremia if unable to tolerate oral water.

What are symptoms of high sodium?

Symptoms of high sodium levels (hypernatremia) include:

  • Excess thirst.
  • Infrequent urination.
  • Vomiting.
  • Diarrhea.


How do pediatrics fix Hypernatremia?

In cases of hypernatremia caused by sodium overload, sodium-free intravenous fluid (eg, 5% dextrose in water) may be used, and a loop diuretic may be added. The serum sodium concentration should be monitored frequently to avoid too-rapid correction of hypernatremia.

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How do I know my newborn is dehydrated?

Parched, dry mouth. Fewer tears when crying. Sunken soft spot of the head in an infant or toddler. Stools will be loose if dehydration is caused by diarrhea; if dehydration is due to other fluid loss (vomiting, lack of fluid intake), there will be decreased bowel movements.

What causes Hypernatremia?

Hypernatremia is usually caused by limited access to water or an impaired thirst mechanism, and less commonly by diabetes insipidus. Manifestations include confusion, neuromuscular excitability, hyperreflexia, seizures, and coma.

When does Hypernatremia occur?

Hypernatremia occurs when the serum sodium concentration is higher than 145 milliequivalents per liter (mEq/l) . It means that the level of sodium in a person’s blood is too high. Two common causes of hypernatremia are insufficient fluid intake and too much water loss.

Does Hypernatremia cause weight gain?

Almost all the patients had hypervolemia as evidenced by the presence of edema and an average weight gain of more than 9 ± 11 kg between the time of presentation and the onset of hypernatremia despite likely having lost muscle mass from being in the intensive care unit for several days.

How do you correct Hypernatremia dehydration?

The most cautious approach is to plan a slow correction of the fluid deficit over 48 hours. Following adequate intravascular volume expansion, rehydration fluids should be initiated with 5% dextrose in 0.9% sodium chloride. Serum sodium levels should be assessed every 2-4 hours.

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