Weight loss and hypernatremia in breast-fed babies: Frequency in neonates with non-hemolytic jaundice

• Published in: Journal of paediatrics and child health Vol. 41; no. 9-10; pp. 484 - 487
• Main Authors: Tarcan, Aylin, Tiker, Filiz, Vatandaş, Nilgün Şalk, Haberal, Ayşegül, Gürakan, Berkan
• Format: Journal Article
• Language: English
• Published: PO Box 378 , Carlton South Victoria 3053 , Australia Blackwell Science Pty 01-09-2005; Blackwell Publishing Ltd
• Subjects: Babies; Breast Feeding; Breastfeeding; Breastfeeding & lactation; Female; Humans; Hyperbilirubinaemia; hyperbilirubinemia; Hypernatraemia; hypernatremia; Hypernatremia - complications; Infant, Newborn; Jaundice, Neonatal - classification; Jaundice, Neonatal - complications; Liver; Male; Medical disorders; newborn; Pediatrics; Prospective Studies; Sick newborn babies; Weight; Weight Loss
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/j.1440-1754.2005.00688.x

Objective:  The aim of this study was to determine what proportion of newborns admitted with idiopathic non‐hemolytic hyperbilirubinemia exhibit severe weight loss and hypernatremia.
Methods:  The prospective study involved 115 infants >48 h old who were admitted with jaundice between July 2002 and July 2003, and had unconjugated bilirubin levels >12 mg/dL. Premature babies (gestational age <37 weeks) and those with hemolytic jaundice and other pathologic causes of non‐hemolytic jaundice were excluded. Postnatal age (days) at admission, bodyweight at admission, weight change since birth (percentage weight loss calculated at admission) and mode of feeding (breast‐feeding, formula feeding, mixed feeding) were recorded. Severe weight loss was defined in babies who showed >10% weight loss or had not regained enough to reach birthweight by postnatal day 10. Serum Na levels and breast‐milk Na levels were also measured.
Results:  Twenty‐eight (33%) of the 86 newborns with idiopathic hyperbilirubinemia in the study exhibited severe weight loss. Almost all the 86 babies were exclusively breast‐fed, and 10 babies (12%) had severe weight loss combined with hypernatremia. The group with severe weight loss and hypernatremia had higher breast‐milk Na levels than the other infants.
Conclusion:  The results indicate that a large proportion of babies with non‐hemolytic jaundice have severe weight loss, and that breast‐fed newborns with the combination of weight loss and hypernatremia may present with non‐hemolytic jaundice.