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Breastfed Children at Risk for Dehydration, Jaundice and Other Complications, Children's Hospital of Pittsburgh Research Shows

Study is published in the September 2005 issue of Pediatrics

During their first week of life, breastfed infants who don't receive enough breast milk are at risk for dehydration that can lead to high sodium levels, jaundice, and even blood clots, seizures and stroke, according to Children's Hospital of Pittsburgh research.

The Children's study found that dehydration among breastfed newborns occurs more frequently than previously assumed and that it is underdiagnosed by pediatricians. And, at least one in 200 breastfed infants is hospitalized with high sodium levels (a condition known as hypernatremia that is a complication of dehydration).

This study indicates that breastfed infants who lose significant weight in the first week of life may need to have breast milk supplemented with formula, said Michael Moritz, MD, a Children's nephrologist and first author of the study. These results show that hypernatremia associated with breastfeeding may be on the rise because of a general reluctance to supplement breastfed infants when excessive weight loss and feeding difficulties occur.

"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," Dr. Moritz said. "We wholeheartedly encourage mothers to breastfeed. However, parents and pediatricians need to be aware that when this occurs, the risk of dehydration is much higher than previously assume. If infants are becoming dehydrated, we strongly recommend that the breast milk be supplemented with formula or breast milk from another source."

Results of the study are published in the September 2005 issue of Pediatrics , a publication of the American Academy of Pediatrics.

Children's study of 70 infants is the largest such study to date (23 previous published research studies had identified only 65 cases of dehydration associated with breastfeeding). Of the 70 patients studied, only four were hospitalized because of weight loss, a sign of dehydration; 47 percent were hospitalized because of poor food intake; and 34 percent because of jaundice, a condition in which bilirubin can accumulate in the body to toxic levels that can cause brain damage and death. A total of 12 of the patients in the study had significant short-term complications from dehydration.

To protect against dehydration in breastfed newborns, Dr. Moritz and study colleagues urge pediatricians to re-check a newborn's weight 24 - 48 hours after hospital discharge from the hospital. If the newborn has lost more than 7 percent of his or her bodyweight, the infant should be evaluated for dehydration and receive supplemental breast milk or formula (until successful breastfeeding is established). Signs of dehydration in newborns include low urine output, decreased stooling, jaundice, lethargy, excess weight loss and fever.

View the study, "Breastfeeding-Associated Hypernatremia: Are We Missing the Diagnosis?"

Marc Lukasiak, 412-692-7919 or 412-692-5016,
Melanie Finnigan, 412-692-5502 or 412-692-5016,

Last Update
February 18, 2008
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Last Update
February 18, 2008