Here’s a study in Pediatric Emergency Care, Vol 29, Number 7, July 2013
“What is the Safe Approach for Neonatal Hypernatremic Dehydration?”
This looks at developmental outcomes based on initial serum Na level and the hourly rate of correction.
One concrete thing the study found is that Na >160 at admission and correction more than 0.5 mmol/L per hour were independent risk factors for death or convulsion.
Criteria to be IN the study to begin with was a serum Na 150.
I guess the question is why the Na was checked in the first place?
I think if I checked a Na in all the babies I see that are >10% under BW, I’d catch a few that are 149. But I guess I don’t check a Na unless the baby appears clinically dehydrated, since the % weight loss can be due to so many factors surrounding the birth process.
With that said, progressing jaundice or any other health concerns would prompt me to check a bit sooner, which again makes me ask why the Na was checked? If there was a health concern that prompted a check of electrolytes, then that is part of the equation when deciding what to do about it.
Hope this helps!
Kay Anderson, MD, IBCLC
> On Sep 18, 2018, at 9:39 AM, Westra, Mary <[log in to unmask]> wrote:
>
> Also looking for normal sodium levels in exclusive breastfeeding infants. Our pediatricians want to supplement with any sodium over 145. An infant I saw yesterday was 3 days old. Mother was a primipara with no risk factors for delayed lactogenesis or for decreased production. Infant had 8% weight loss and sodium of 149. Only drops of colostrum were expressed. Pediatrician ordered formula supplementation. Blood sugar was normal.
> Thanks,
> Polly Westra R.N., IBCLC
>
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