Document Type : Original Article
Authors
1
Associate Professor, Department of Pediatrics, Neonatal Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Pediatrician, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3
Professor, Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4
Associate Professor, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Introduction: Decrease in breast milk intake during the first days of birth can lead to weight loss, hypernatremia and severe hyperbilirubinemia. Few studies have investigated the relationship between jaundice and hypernatremia. So, this study was done to assess the relationship between hypernatremia and its effective factors on breast-fed term infants with jaundice of unknown etiology.
Methods: This prospective and cross sectional study was conducted on 273 neonates with jaundice of unknown etiology who were admitted to Qaem hospital of Mashhad, Iran, from February 2009 to January 2011. Neonates were enrolled in control group (serum sodium less than 150 mmol/L, n=226) and case group (serum sodium less than 150 mmol/L, n=47). Maternal and neonatal characteristics and risk factors in two groups were compared. Data were analyzed using SPSS software version 16, Pearson correlation test, independent t-test, ANOVA and Mann-Whitney. P value less than 0.05 was considered significant.
Results: Number of feeding, sucking difficulties, number of urination, first time of breastfeeding, let down reflex, mastitis, hardening of the breast before breastfeeding, softening of the breast after breastfeeding and feeding position were significant in two groups (p<0.05). Correlation between severity of hypernatremia and severity of weight loss was significant (p<0.001)
Conclusion: Mastitis, insufficient let down reflex, inappropriate feeding position, delay in first feeding, less feeding frequency, less urinary frequency and severity of neonatal weight loss are the important risk factors of hypernatremia in neonates.
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