In plain words
Hypernatremic dehydration is a condition in which a newborn loses more water than salt, so the sodium level in the blood rises. It usually comes from too little over several days. The baby may be sleepy, weak, or hard to wake. There may be fewer wet diapers, a dry mouth, or a high-pitched cry. It is rare in babies who are feeding well and gaining weight. Clinicians separate expected newborn weight loss from loss that reflects low intake. It can make harder to manage. A baby who is hard to wake needs care right away, including emergency care. If you notice very sleepy behavior, poor feeding, or few wet diapers, call the baby's provider now.
The deeper version
Hypernatremia is defined as serum sodium above 145 mmol/L. In exclusively breastfed newborns it usually results from inadequate milk transfer, with a free-water deficit that drives serum sodium upward. Presentation includes weight loss beyond expected thresholds, lethargy, and high-pitched crying. Untreated, it can progress to seizures and intracranial hemorrhage. Early weight loss nomograms (Flaherman and colleagues, Pediatrics, 2015) help separate expected from excessive loss. The AAP policy statement on breastfeeding (Eidelman and colleagues, 2012) notes that dehydration is uncommon once feeding is well established. Most data come from case series, so the threshold for admission and the best rehydration approach are not settled.
Where it comes up
- Is my baby getting enough?Feeding Your Baby
- Newborn weight: the early drop and regainingBaby Basics
- Newborn jaundiceBaby Basics
What mothers here say about hypernatremic dehydration
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Sources
- Flaherman VJ et al. — Early weight loss nomograms for exclusively breastfed newborns. Pediatrics, 2015
- American Academy of Pediatrics — Breastfeeding and the Use of Human Milk, policy statement, 2012