Severe hypernatremia in newborns due to salting

Abstract

The aim of this study was to evaluate the etiology, clinical, and laboratory findings and prognostic features of life-threatening hypernatremic newborns secondary to salting. Ten severely hypernatremic newborns (four females) with a mean age of 6.5 +/- 2.6 days were followed up. Nine of them were full term, and one was preterm. It was noticeable that 60% of them were small for gestational age. In the laboratory investigation, five uremias were detected. It was interesting to find in the etiologic history that 40% of the patients had been salted just after birth. Twenty percent of them had also hyperbilirubinemia and kernicterus, 20% had neonatal convulsion, and 50% had dehydration. Two of the hypernatremic newborns died during the study; the others were followed up. One case had spasticity and developmental disability at the 3rd month, and another one had developmental disability at the 6th month of ages. As a conclusion, although salting of newborns is not so frequent, it could be seen in rural places of our country, and this may be one of the reasons for serious hypernatremia in newborns whose skin integrity have not been formed completely. These cases should be treated carefully.

Treatment of Hypernatremia in Breastfeeding Neonates: A Systematic Review

“…In 6 cases, after the calculation of maintenance and lost fluid, 5% dextrose and 0.2% NaCl solutions were administered. In this group, normal SNa was reached earlier, with a mean period of 48 h. Two of the hypernatremic newborns died during the study (due to meningitis and kernicterus) [28] .…”

“…The study by Peker et al [28] included 10 newborns (1 preterm, 60% of small for gestational age). Fluid with a sodium concentration of 75-100 mEq/L was administered to 4 neonates and it took more than 72 h to achieve SNa concentrations lower than 150 mEq/L.…”

“…One article was a case series of neonates with severe hypernatremia treated with peritoneal dialysis (PD), and we decided to keep it in the review due to its data regarding outcomes of this specific therapy [25] . Three articles included late preterm infants [22,26,28] and we also decided to keep it in the review as these sample included otherwise healthy neonates whose only likely predisposing factor related to hypernatremic dehydration was inadequate breastfeeding. These infants had a birth weight >2,000 g and were not admitted for other issues related to prematurity.…”

“…There is no randomized clinical trial focusing on the treatment of hypernatremia in term neonates. Only 2 retrospective studies provided some comparison among different treatment strategies and a more thorough evaluation regarding the rate of correction of SNa [10,22] , whereas the remaining studies provided descriptions of treatment options and outcomes without details of which solution was used [21,[23][24][25][26][27][28] .…”

Traditional practices of Konya women during pregnancy, birth, the postpartumperiod, and newborn care

“…Considering the sensitivity of a baby's skin, salting a newborn is harmful because it may cause pain, hypernatremia, and body dehydration, and may injure or redden the skin (46,47).…”