© 2002 Archives of Disease in Childhood Fetal and Neonatal Edition
Fantoms
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Hypernatraemic dehydration in breast fed infants has long been recognised as an uncommon but serious health risk in early life. Parents and other carers may not recognise that the milk intake is inadequate until severe dehydration has developed, with devastating consequences. Although this it not a new disease, reports from several centres justify concerns that it may be occurring with increased frequency. Earlier discharge from hospital after birth and increased emphasis on exclusive breast feeding may be contributors. Laing and Wong describe their experiences with this problem and review the literature, giving recommendations for the prevention, identification, and management of cases. See p158
A confidential enquiry using methods adapted from CESDI examined 49 cases of neonatal encephalopathy cared for in the Trent Region in 1997. Suboptimal care, in which different management would reasonably be expected to have made a difference to the outcome, was found in 44% of cases
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