Decoding Neonatal Hypernatremic Dehydration: Risk Factors and LATCH Score Correlation in a Case-control Study

Abstract

Background

The LATCH score is a reliable tool for assessing breastfeeding efficiency. The objectives of this study were to identify risk factors for hypernatremic dehydration in exclusively breastfed neonates, including the correlation between serum sodium levels and LATCH scores.

Methods

This single-center, hospital-based, case-control study (February 2022 to March 2024) enrolled 37 exclusively breastfed neonates with hypernatremic dehydration as cases, and 37 healthy, exclusively breastfed neonates without any signs or symptoms of dehydration and with normal serum sodium levels as controls. LATCH scores were assessed and correlated with serum sodium levels.

Results

The mean ± SD serum sodium levels were 171 ± 9.95 mEq/L in cases and 143 ± 3.53 mEq/L in controls. Univariate analysis revealed that poor attachment, delayed initiation of breastfeeding, lower feeding frequency, jaundice, irritability, convulsions, hypertonia, poor suck, and a hyper alert state were significantly associated with hypernatremic dehydration. Poor attachment/sucking at the breast, irritability and hyper alert state emerged as independent predictors of hypernatremia. A higher proportion of babies with hypernatremic dehydration (54%) had poor LATCH scores (<7) as compared to controls (45.95%). Among cases, a moderate negative correlation (r = –0.400) was observed between serum sodium levels and LATCH scores. Moderate inverse correlations were also observed with the T (–0.41) and C (–0.43) components, while the L (–0.10) and H (–0.23) components showed weak correlations. No correlation was noted with the A component (–0.02).

Conclusions

Hypernatremic dehydration in exclusively breastfed neonates is significantly associated with poor feeding behaviors and certain clinical signs. A combination of clinical vigilance and breastfeeding assessment (including tools like the LATCH score) can aid in the early identification and prevention of this potentially serious condition.