Re: Debbie's post.  I have worked with numerous infants admitted to our
facility with hypernatremic dehydration.  Typically, the milk supply is
extremely low and the sodium content of the milk quite high.  If the
primary cause was the infant being unable to obtain the milk from the
breast, pumping will often time bring back the supply and with this the
sodium levels return to normal.  If the cause was primary lactation failure,
pumping has not been successful.  This is extremely serious with infants
at times requiring admission to the Pediatric ICU, requiring intubation
(being put on a ventilator).  The sodium levels in the infant are high and
must be brought down very slowly.  Although, I always obtain a
breastfeeding history from the mom, experience has proved  that the
moms perception of "breastfeeding going well", may be entirely different
than my perception or what I observe.

Laura Wham, RN, IBCLC
Primary Children's Medical Center
Salt Lake City, Utah