The declining incidence of infantile hypernatremic dehydration in Great Britain
D. P. Davies, B. M. Ansari and B. K. Mandal
The feeding habits of 70 infants under 6 months old hospitalized with acute
gastroenteritis were studied to determine whether current efforts to
discourage high-solute feeding were having an effect on the incidence of
hypernatremic dehydration. Fifteen infants (21%) were fed modified
(low-solute) milks and 55 (79%) unmodified (high-solute) milks. Of 47
infants under 3 months old, 15 (32%) had commenced mixed feeding. Plasma
sodium level was estimated in 60 infants. Mean values in the modified and
unmodified groups were the same, at 137 mEq/liter. Only one infant was
hypernatremic (sodium level, 152 m/eq/liter). Osmolalities of 65 samples of
milk were measured to provide a measure of milk concentration. Only ten
(16%) exceeded by more than 25% that recommended by the manufacturers.
Twenty-two (34%) were less than 75% of the recommended concentrations.
These improved feeding practices have probably contributed largely to the
very low incidence of hypernatremia by preventing dangerously high solute
intakes at a time of particular vulnerability.
