NepMed Repository :: Browsing by Author "John, Sangeetha Rachel"

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The Threat Beyond Weight Loss: A Case Series on Severe Neonatal Hypernatremic Dehydration
(Perinatal Society of Nepal (PESON), 2025) John, Sangeetha Rachel; Rahul, Aswathy; Sujatha, Radhika
Abstract: Neonatal hypernatremic dehydration, often resulting from suboptimal breastfeeding, is a life-threatening condition characterized by severe electrolyte imbalances. Lack of awareness about postnatal weight monitoring delays diagnosis. Severe hypernatremia (Serum sodium > 170 mEq / L) can cause acute kidney injury (AKI), disseminated intravascular coagulation (DIC), cerebral edema and death. We wanted to describe the clinical profiles, complications, and outcomes of neonates with severe hypernatremic dehydration due to suboptimal breastfeeding. The case series describes eight neonates admitted with severe hypernatremic dehydration in our NICU. All neonates were exclusively breastfed. Poor feeding was noted in 87.5% neonates. 12.5% presented in gasping respiration with severe metabolic acidosis requiring intubation, 62.5% had shock, 87% had AKI, 37.5% had seizures and 20% had intracranial bleeding. One neonate died from cerebral edema; another developed limb gangrene. This case series highlights the importance of prevention of dehydration from suboptimal breastfeeding with early postnatal weight monitoring and timely interventions.