Title
A nationwide study on hospital admissions due to dehydration in exclusively breastfed infants in the Netherlands: Its incidence, clinical characteristics, treatment and outcome
Author
Pelleboer, R.A.A.
Bontemps, S.T.H.
Verkerk, P.H.
van Dommelen, P.
Pereira, R.R.
van Wouwe, J.P.
TNO Kwaliteit van Leven
Publication year
2009
Abstract
Aims: To estimate the incidence and clinical characteristics in hospital admissions due to dehydration or undernutrition and their laboratory evaluation and treatment outcome in exclusively breastfed infants. Methods: All hospital admissions during the first 3 months of life assessed by the Dutch Paediatric Surveillance Unit (DPSU) between mid 2003 and mid 2005. Results: Nationwide 158 cases reported, correspond to an incidence of 58/y/100 000 breastfed infants; it is lower for severe dehydration at risk for hypernatraemia; 20/y/100 000. Sixty-five per cent of cases were <2 weeks old, their median weight loss was 9.3% and median age at admission 5 days; Serum sodium value was measured in only 12% of all cases. Insufficient volume intake and inadequate growth were most frequently reported (61% and 41%). Lethargy, jaundice or clinical dehydration was scored in 11-25%, seizures or shock in 3%. A breast pump at home was used in only 31%. In the hospital breast pumps were available (82%) as lactation consultants (73%). For treatment 65% was offered formula, in 30% by nasogastric drip. Most admissions lasted up to 3 days, all recovered fully and 33% were breastfed exclusively at discharge. Conclusion: The incidence of severe dehydration in the Netherlands is relatively low. With extended use of breast pumps at home it could be lower. To prevent complications, we recommend applying a reference weight chart, a full clinical examination and more extensive screening of serum sodium and glucose. ©2009 Foundation Acta Pædiatrica/Acta Pædiatrica.
Subject
Health
Jeugd en Gezondheid
Epidemiology
Sodium
Artificial milk
Breast milk
Breast pump
Clinical examination
Clinical feature
Controlled study
Glucose blood level
Hospital admission
Human
Hypernatremia
Incidence
Jaundice
Laboratory test
Lethargy
Major clinical study
Malnutrition
Risk assessment
Scoring system
Seizure
Shock
Sodium blood level
Weight reduction
Breast Feeding
Dehydration
Female
Hospitalization
Humans
Incidence
Infant
Infant, Newborn
Male
National Health Programs
Netherlands
Treatment Outcome
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DOI
https://doi.org/10.1111/j.1651-2227.2009.01230.x
TNO identifier
241501
ISSN
0803-5253
Source
Acta Paediatrica, International Journal of Paediatrics, 98 (5), 807-811
Document type
article