>Can anyone answer a question for me? Is it possible for a baby >wiith severe hypernatraemic dehydration, say with nearly 25% weight >loss, to be passing normal quantities of normal urine? Thus >throwing to the winds the normal advice for a mother to count wet >nappies/diapers as a way to know her baby is taking in enough >breastmilk. I've just heard of 2 such cases and I'm wondering what >could have happened. > >This really bothers me because it seems so unlikely and I've been >asked to comment to a healthcare professional. > >My knee-jerk reaction would be to think that a baby breastfeeding so >seldom, or so infrequently as to have become dehydrated might >suddenly have been fed a large quantity of formula, so causing >hypernatraemia. > >Can anyone come up with a likely explanation?? > >Many thanks if you can help. > >Pamela Morrison IBCLC >Rustington, England My understanding is that not urinating is a very late stage - I have come across a number of babies who were admitted for HD, with serious weight loss, and it was only the one with the massive weight loss (sticks in my mind because I wrote her up as a formal case study) where there was noticably less urine. I have come across a number of mothers who were worried about the baby's intake, and were told 'as long as he is weeing, he is fine' and the babies were *not* *fine*. I think one issue is that it is impossible with today's super-absorbent nappies to estimate urine loss - the trick of putting in a cloth or a cotton wool ball inside to show up urine loss helps a bit, but I have no idea how this would be counted in 'voids'. Two or three urinations could happen in between nappy changes! It's sensible I think to watch for a 'heavy' nappy - in the sheet I co-wrote for NCT on 'what's in a nappy?' we encourage mothers to look for 'heavy' nappies, and to test what one should feel like by placing water from a spoon into a dry nappy and then lifting it. I am sure hardly anyone would do this though ;) All the babies with HD treated in hospital have had the same symptom though - lack of stooling. And this is easy to spot, and easy to monitor by counting. Lack of stooling happens before lack of urination. Heathetr Welford Neil NCT bfc, tutor, UK *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome