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INEFFECTIVE BREASTFEEDING IN THE INFANTS
Category: Child Health
Abstract : Warning signs of ineffective breastfeeding in the infants What are the warning signs of ineffective breastfeeding in the infant? For example, if milk production is inadequate secondary to poor latch-on or infrequent breastfeeding, the infant may become dehydrated with a concurrent increase in his or her sodium level. Prolonged hyperbilirubinemia may accompany the dehydration. Dehydration occurs
Warning signs of ineffective breastfeeding in the infants
What are the warning signs of ineffective breastfeeding in the infant? For example, if milk production is inadequate secondary to poor latch-on or infrequent breastfeeding, the infant may become dehydrated with a concurrent increase in his or her sodium level. Prolonged hyperbilirubinemia may accompany the dehydration.
Dehydration occurs over days to weeks, depending on the milk supply and the frequency of breastfeeding. In rare cases, the sodium concentration may be as high as 180 mmol/L. Nothing may be inherently wrong with the mother's milk, but if it is not adequately removed from her breasts, either by suckling or by pumping, the milk becomes weaning milk with a higher sodium concentration.
The main reason that the sodium level increases in the infant, however, is volume contraction secondary to dehydration and insufficient water in the milk. Human milk is 87% water, but its composition changes if an insufficient amount of milk is removed from the breast. The treatment of an infant with hypernatremic dehydration is to replace the free water losses slowly, because an abrupt decrease in the sodium level can trigger seizures secondary to cerebral edema and the rapid flux of sodium concentrations. This treatment involves giving the infant intravenous fluid with decremental concentrations of sodium to achieve a normal serum sodium level.
Another warning sign of ineffective breastfeeding is failure to thrive in the breastfeeding infant, which also results from an insufficient milk supply. An infant can have both hypernatremic dehydration and failure to thrive. These disorders occur along a spectrum depending on whether the milk produced is adequate to maintain the infant's hydration state but insufficient to allow adequate growth.
The primary care provider must assess the growth of the breastfeeding infant over time. Neonates typically regain their birth weight by 2 weeks of age, and their weight should increase by 50% at age 6-8 weeks. At 4-5 months of age, the baby's weight should be double his or her birth weight. Also, the infant's head circumference and length should be assessed.
The monitoring of subcutaneous fat deposition also aids the clinician in assessing the adequacy of growth. An infant's growth should follow the growth curve. Failure to thrive in an infant should not be attributed to breastfeeding without an exploration of other differential diagnoses. The mother whose infant is failing to thrive should be encouraged to breastfeed with close assistance and, possibly, short-term supplementation. Daily visits for weight checks and overall health assessments are often necessary. In rare cases, hospitalization may be indicated.
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