Exclusive breast feeding and dehydration fever in newborns during the first days of life

Abstract

Objectives: To determine the prevalence of dehydration fever in infants admitted to the Neonatal Intensive Care Unit (NICU) from the well newborn nursery with fever in the first days of life.

Study design: Retrospective data analysis of term infants admitted to the NICU from the well newborn nursery with fever (n = 75). Infants were divided into two groups based on hydration status using clinical and laboratory signs of dehydration. Clinical and laboratory variables were compared between the two groups.

Results: Fifty-three of the 75 infants admitted to the NICU with fever had clinical and laboratory signs of dehydration (71%). Infants with dehydration were more likely to be exclusively breast fed and present with fever at >24 h of age. There were no positive blood or cerebrospinal fluid cultures in infants with dehydration. The incidence of dehydration fever increased after implementation of an “Exclusive Breast Feeding” policy from 1.4/1000 to 3.5/1000 live births (p ≤ .01).

Conclusions: Dehydration is associated with fever in exclusively breast fed infants during the first several days of life. There were no cases of serious bacterial or viral infections in the cohort of febrile infants with clinical and laboratory signs of dehydration.

Keywords:

• Baby friendly hospital initiative
• neonates
• infants
• early onset sepsis
• neonatal fever
• dehydration
• hypernatremic dehydration

Acknowledgements

This study was presented in part at the Eastern Society for Pediatric Research Annual Meeting, Philadelphia, PA in March 2015 and the Annual Meeting of the Pediatric Academic Societies, San Diego, CA, in April 2015.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Institutional Development Award (IDeA) (Aghai) from the National Institute of General Medical Sciences of the National Institutes of Health under grant number U54-GM104941 (PI: Binder-Macleod) and NIH COBRE P30GM114736 (PI: Thomas H Shaffer).