Hypernatraemia in the first few days: is the incidence rising?

ypernatraemic dehydration is a potentially lethal condition and is associated with cerebral oedema, intracranial haemorrhage, hydrocephalus, and gangrene. 1 The infant's plasma sodium concentration is raised predominantly because of loss of extracellular water. In the past, hypernatraemia occurred most often when artificial feeds of too high a sodium concentration were fed to babies. 2 This was more common in infants who were fed powdered milk, especially if the mother added extra scoops of powder and failed to provide enough water in the mixture. The resultant hypernatraemia may have stimulated the child's thirst, and further feeds high in sodium would exacerbate the problem. Manufacturing reductions in the solute load of infant formulae, brought about by reports from the Department of Health and Social Security on Present day practice in infant feeding (1974) 3 and Artificial feeds for the young infant (1980), 4 did much to reduce the incidence of this problem. Education of the community and production of proprietary milks in liquid form may also have helped to solve this problem.