Peripheral Gangrene in a Breast Fed Neonate—Is Hypernatremic Dehydration the Cause?

Abstract

Hypernatremic dehydration in breast fed neonates is a rare but increasingly recognized problem. If not identified early, it may lead to potentially life threatening complications. The authors describe a neonate who developed thrombosis and lower limb ischemia secondary to hypernatremic dehydration. Peripheral gangrene, as a result of hypernatremic dehydration is extremely uncommon and has rarely been reported before.

Left lower Limb Gangrene Following Diarrhoeal Disease and Dehydration in a child with Transposition of the Great Arteries

“…In neonates and young infants on exclusive breastfeeding, occurrence of peripheral gangrene was also linked to hypernatraemic dehydration resulting from inadequate fluid intake. 4,12 As explained by Kotbyet al 2 , dehydration causes hypovolaemia and haemoconcentration, which can precipitate hyperviscosity. The latter results in stasis that may lead to hypercoagulable state and tendency for thrombus formation.…”