On Jan. 16, Jill Meltzer wrote:
I had a mom see me in clinic today who was "forced" to wean her
baby because of postpartum depression and the doctor told her
unless she weaned he would not prescribe the zoloft for her.
He also told her that because her baby was now constipated and
gassy, whe should overdilute all ABM bottles 3:1, instead of
2:1 (scoops to water). Does anybody have any articles or some-
thing concrete regarding the potential risks of water intoxication
or hyponatremia from doing this. How much water is too much?
I tried to search the net, but not much luck with what I want.
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I asked my husband, Phil, to do the search.
Here are the results andthe search strategy:
Phil Barnett [log in to unmask]
Sarah Friend Barnett [log in to unmask]
Database: Medline (OVID Version) 1966 - December 1996
Set Search
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1 water intoxication/ or water intoxication.tw.
2 hyponatremia/ or hyponatremia.tw.
3 bottle feeding/
4 (bottle feeding or bottle fed).tw.
5 (1 or 2) and (3 or 4)
<1>
Unique Identifier
93035106
Authors
Newman J.
Title
Water intoxication: a problem of bottle-feeding [letter; comment].
Source
American Journal of Diseases of Children. 146(10):1131-2, 1992 Oct.
<2>
Unique Identifier
92280711
Authors
Patton C. Shyken J.
Title
Water intoxication [letter].
Source
American Journal of Diseases of Children. 146(6):659, 1992 Jun.
<3>
Unique Identifier
92280710
Authors
Graham GG.
Title
Water intoxication [letter; comment] [see comments].
Source
American Journal of Diseases of Children. 146(6):658-9, 1992 Jun.
<4>
Unique Identifier
89215036
Authors
Shohat M. Levy I. Levy Y. Nitzan M.
Institution
Department of Pediatrics, A. Beilinson Medical Center, Petah Tikva,
Israel.
Title
Nutritional complications in an infant fed exclusively on homemade sesame
seed emulsion.
Source
Journal of the American College of Nutrition. 8(2):167-9, 1989 Apr.
Abstract
A 3-month-old infant was exclusively fed a high calorie homemade sesame
seed emulsion for 4 weeks. As a result of the milk content, the infant
developed hypermagnesemia, hypokalemia, hyponatremia, and hypovitaminosis
C. Although the mixture was highly caloric and the infant's intake was
good, he showed profound failure to thrive. Analysis of the emulsion
indicated that this complication was primarily due to the heterogeneity of
the emulsion's caloric content resulting from a settling process which
occurred after the emulsion was placed in the infant's bottle. This
settling resulted in the portion containing the most calories being the
last to reach the infant's mouth. These findings indicate that whenever a
vegetarian diet is provided to a bottle-fed infant, the potential
heterogeneity of the mixture's caloric content, as well as the contents
themselves, should be considered.
<5>
Unique Identifier
88327521
Authors
Lin GH. Huang FY. Hsu CH. Chyou SC. Lee YJ. Chang KL.
Title
[Neonatal water intoxication secondary to feeding mismanagement].
[Chinese]
Source
Chung Hua i Hsueh Tsa Chih - Chinese Medical Journal. 39(2):131-4, 1987
Feb.
<6>
Unique Identifier
87146156
Authors
Callanan DL. Hiner LB.
Title
Vulnerable sibling: hyponatremia from caries prevention.
Source
Pediatrics. 79(4):637-9, 1987 Apr.
<7>
Unique Identifier
83253070
Authors
Pizarro D. Posada G. Villavicencio N. Mohs E. Levine MM.
Title
Oral rehydration in hypernatremic and hyponatremic diarrheal dehydration.
Source
American Journal of Diseases of Children. 137(8):730-4, 1983 Aug.
Abstract
Ninety-four well-nourished, bottle-fed infants with hypernatremic (N = 61)
or hyponatremic (N = 33) diarrheal dehydration were treated with oral
rehydration. In 61 hypernatremic and 25 hyponatremic infants, two thirds
of the fluid volume were given as glucose/electrolyte solution containing
90 mmole of sodium per liter and one third as plain water; the other eight
hyponatremic infants were given glucose/electrolyte solution alone. Fluid
deficits were successfully and rapidly replaced with oral therapy alone in
all 61 hypernatremic infants (mean +/- SEM, 8.5 +/- 0.6 hours) and in 31
of those with hyponatremia (mean +/- SEM, 10 +/- 1.2 hours). Two
hypernatremic infants required some intravenous (IV) fluids. The mean
serum sodium levels fell in the hypernatremic infants to normal and rose
in those with hyponatremia. Only five (8%) of the 61 hypernatremic infants
manifested convulsions during oral rehydration; this compared favorably
with the 14% rate of convulsions encountered previously when we used IV
rehydration.
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