It is extremely unlikely that the child died of the mother's high sodium in
the milk.  This is backwards.  What likely happened is the baby never got
breastfeeding properly and died of dehydration (and had a very high serum
sodium on admission to hospital).  The doctors, not realizing the baby
wasn't breastfeeding (because they don't watch), had read that this happens
in some books or publications, tested the milk and found it had high levels
of sodium.  Voilà the answer. But that is because this was "weaning" milk,
not because the mother likely had some rare disorder.  When a mother weans a
child, the milk starts increasing its sodium, this is natural.  A baby not
breastfeeding properly tells the brain there is no baby or the baby is
weaning, and the sodium rises.

The high sodium does not explain the almost certain large weight loss this
baby had, nor the fact that the baby was not peeing.

In the old days, babies did okay on straight homogenized milk which
contained sodiums of 50 to 60 meq/l, compared to breastmilk which has 7
meq/l.  As long as they didn't get gastroenteritis, in which case they could
become hypernatremic.

This woman needs to see someone who knows what s/he is doing before she
delivers to get her information about how breastfeeding works, and guide her
through the first few days.

Jack Newman, MD, FRCPC

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