Weight Loss and/or Hypernatraemia in Inadequately Breastfed Term Neonates having Non-haemolytic Unconjugated Hyperbilirubinaemia SC01-SC04
Dr. Sushma Malik,
Block No 3, Flat No 7, Bradys Flats, Colaba, Mumbai-400001, Maharashtra, India.
Introduction: Insufficient breast milk intake can lead to increased incidence of neonatal jaundice, inadequate weight gain, hypernatraemic dehydration in neonates and occasionally may cause serious complications.
Aim: To know the proportion of neonates admitted with non-haemolytic unconjugated hyperbilirubinaemia exhibit inadequate weight gain and hypernatraemia and their relationship to breastfeeding pattern.
Materials and Methods: We conducted a prospective observational study at the Neonatal Intensive Care Unit (NICU)/Postnatal Care (PNC) ward of our tertiary care hospital, over a period of one year. We enrolled 60 full term neonates with birth weight >2500 gm and >48 hours old, who were admitted for non-haemolytic unconjugated hyperbilirubinaemia. These neonates were evaluated for daily weight, serum sodium levels, mother’s milk sodium levels and breastfeeding patterns. Mean, median and standard deviation were calculated for all the quantitative parameters. The correlations between various study parameters were assessed with the help of chi-square test and Pearson’s correlation coefficient.
Results: Analysis revealed that maximum neonates 55 (91.6%) presented with hyperbilirubinaemia in the first week of life and 50 (83%) neonates were on exclusive breastfeeding. There were 21(33%) neonates with significant weight loss of >10% and of these seven (33.3%) had hypernatraemia, whereas in 39 babies who had no significant weight loss only two babies had hypernatraemia. This difference was found to be statistically significant (p-value=0.004). There were high mother’s milk sodium levels in neonates with weight loss and hypernatraemia (p=0.017). Incidence of combined weight loss and hypernatremia among all studied hyperbilirubinemic neonates was 12%. The weight loss pattern in babies was similar in multiparous or primiparous mothers and there was no statistical association of weight loss with parity (43% vs 30% respectively).
Conclusion: We observed that a significant proportion of neonates admitted with unconjugated hyperbilirubinaemia which were inadequately breastfed had severe weight loss and hypernatraemia. High mother’s milk sodium levels in subset of babies with severe weight loss can suggest the possibility of lactation failure in their mothers.