Ülfet VATANSEVER, Rıdvan DURAN, Betül ACUNAŞ

Tek başına anne sütü ile beslenen bebeklerde hipernatremik dehidratasyon

Yenidoğan yoğun bakım ünitesine şiddetli hipernatremik dehidratasyon nedeni ile yatırılan, tek başına anne sütü ile beslenmiş olguların özellikleri değerlendirildi. Hastalar ve Yöntemler: Son iki yılda sadece anne sütü ile beslenmiş, serum sodyum değeri 150 mEq/L’den daha yüksek ve dehidratasyon bulguları olan 14 yenidoğan (10 kız, 4 erkek; ort. gebelik yaşı 38±1.7; dağılım 34-40 hafta) geriye dönük olarak yatış dosyaları incelenerek değerlendirildi. Bulgular: Olguların %71’i kızdı. Doğum tartıları ortalama 3020±715 gr idi. Olguların %93’ü AGA ve %78.6’s› ailenin ilk bebeğiydi. Anne yaşları ortalama 28±5.4 yıldı. %57 olgu sezaryenle ve %57 olgu çevre hastanelerde doğmuştu. En sık başvuru nedeni emmeme ve ateşti, başvurular ortalama 5.5±4.6 günde yapılmıştı. Başvuru sırasında hesaplanan tartı kayıpları %14.5±9.1, ortalama serum sodyum değeri 158.5±14 mEq/L, serum üre değeri 73±109 mg/dl, serum kreatinin 1.2±2.1 mg/dl, serum osmolaritesi 338±35 mOsmol/L idi. Sonuç: Olguların çoğunun ilk bebek olması ve sezaryen ile doğmaları dikkat çekiciydi. Hipernatremik dehidratasyonun gelişmemesi için anneye mutlaka iyi bir emzirme danışmanlığının verilmesi uygun olacaktır.

Anahtar Kelimeler:

Geriyedönük çalışma, Süt çocuğu, Hipernatremi, Su kaybı, Anne sütüyle beslenme

Hypernatremic dehydration in exclusively breast-fed infants

The characteristic features of exclusively breast-fed infants with hypernatremic dehydration in our neonatal intensive care unit were evaluated. Patients and Methods: Within the last two years, fourteen exclusively breast-fed newborn infants (10 females, 4 males; mean gestational age 38±1.7; range 34 to 40 weeks) whose serum sodium level was equal to or greater than 150 mEq/L with signs of dehydration were evaluated from clinical charts retrospectively. Results: 71% of all cases were girls. Mean birth weight was 3020±715 gr. 93% of the cases were AGA and 78.6% were first child of the family. Mean age of mothers was 28±5.4 years. 57% of the cases were born by cesarean and 57% were referred to our hospital from different hospitals. The most common presenting complaint was fever and refusing sucking; and mean application time was 5.5±4.6 days. On the admission, mean weight loss was 14.5±9.1%, serum sodium level 158.5±14 mEq/L, serum urea level 73±109 mg/dl, serum creatinine level 1.2±2.1 mg/dl, and serum osmolarity 338±35 mOsmol/L. Conclusion: It was remarkable that the cases were mostly first babies and born by cesarean section. A possible solution for hypernatremic dehydration would be to provide breast feeding consultancy to mothers.

Keywords:

Retrospective Studies, Infant, Hypernatremia, Dehydration, Breast Feeding,

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