Neonatal dehydration and neurodevelopment

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Dehydration at any age can have severe consequences. Neonatal dehydration generally results from inadequate fluid intake, often as a result of inadequate breast-feeding. Such infants also can have elevated bilirubin values and often get extensive evaluations for possible infection. Dehydration in the neonate also is frequently associated with hypernatremia. Escobar et al identified a large number of infants that were admitted for hospital management of dehydration of >12% of birth weight, often with a serum sodium ≥150 mEq/L. At follow-up, there was no evidence of adverse neurodevelopmental outcomes. Larry Finberg comments in an accompanying editorial that this sort of neonatal dehydration is generally more benign than dehydration resulting from gastroenteritis. The results are reassuring when the clinician is faced with the dehydrated neonate, but these infants need careful management to assure successful feeding after treatment for the dehydration.