The Declining Incidence of Infantile Hypernatremic Dehydration in Great Britain

Abstract

\s=b\The feeding habits of 70 infants under 6 months old hospitalized with acute gastroenteritis were studied to determine whether current efforts to discourage high-solute feeding were having an effect on the incidence of hypernatremic dehydration. Fifteen infants (21%) were fed modified (low-solute) milks and 55 (79%) unmodified (high-solute) milks. Of 47 infants under 3 months old, 15 (32%) had commenced mixed feeding. Plasma sodium level was estimated in 60 infants. Mean values in the modified and unmodified groups were the same, at 137 mEq/ liter. Only one infant was hypernatremic (sodium level, 152 mEq/liter). Osmolalities of 65 samples of milk were measured to provide a measure of milk concentration. Only ten (16%) exceeded by more than 25% that recommended by the manufacturers. Twenty-two (34%) were less than 75% of the recommended concentrations.These improved feeding practices have probably contributed largely to the very low incidence of hypernatremia by preventing dangerously high solute intakes at a time of particular vulnerability.

Hypernatremia in Children With Diarrhea

“…Moreover, our overall observation of a low incidence of hypernatremic dehydration over the years has been reported in earlier studies. 1,38,39…”

Formula feed preparation: helping reduce the risks; a systematic review

“…[16][17][18][19] Furthermore, babies most likely to be artificially fed in westernised populations are those who come from lower socioeconomic groups 12 ; these babies already suffer increased morbidity 39 and their parents are those least likely to be able to afford the expensive ready-to-feed preparations. The price variation between products is considerable, with ready-to-feed preparations two or three times more expensive than powder and scoop (table 4).…”

Severe Hypernatremia with Impaired Thirst

“…It is not altogether surprising that clinically severe hyperna tremia has been described most frequently in those two groups of patients whose ability to maintain or increase water intake are most vulnerable -infants and the elder ly. It was recognized recently that the frequency and severity of episodes of hypernatremia in infants with gas troenteritis was related, at least in part, to the use of overconcentrated dry milks, the early introduction of mixed feedings and preliminary home therapy of gas troenteritis with strong salt and sugar solutions [36], Apparently a result of this new information, improved feeding practices with the use of oral replacement solu tions such as that recommended by the World Health Organization have reduced the incidence of serious hy pernatremia in infantile gastroenteritis [36]. The focus of attention recently has been on hypernatremia in the adult [37], particularly in the geriatric population [38][39][40][41][42][43][44][45].…”