Dehydration fever in exclusively breastfed neonates at a tertiary care center – A cross-sectional study

Background: Dehydration fever is one of the most common non-infectious causes of fever in newborns. It can be very dangerous and can lead to serious complications and even death. Early recognition of dehydration fever by serial monitoring of weight to detect inappropriate weight loss and early correction of dehydration fever can prevent disastrous complications in the baby. Aims and Objectives: The aim was to study the incidence and clinical profile of dehydration fever in exclusively breastfed neonates admitted at tertiary care hospital. The primary objective is to know the incidence of dehydration fever in exclusively breastfed neonates. Secondary objectives are to study the clinical and laboratory profile of dehydration fever and to study the management and outcome of dehydration fever in terms of morbidity and mortality. Materials and Methods: The study was conducted in the Department of Pediatrics of a tertiary care hospital in Ahmedabad, Gujarat. Neonates between 0 and 28 days of life born at full term (37–40 weeks of gestation), on exclusive breastfeeding and having an axillary temperature of >37.5°C/100.4°F and clinical signs of dehydration were included in the study. Clinical and laboratory profile of neonates with dehydration fever was noted. Results: The incidence of dehydration fever was 4.71/100 neonates (152 out of 3225 neonatal admissions). Maximum cases were noted in May. The most common predisposing factor was primiparity (n = 119 [78.28%]), followed by the poor establishment of breastfeeding (n = 117 [76.97%]) and cesarean section delivery (n = 97 [63.81%]). Among 152 neonates with dehydration fever, 118 neonates (77.64%) had hypernatremic dehydration and 34 (22.36%) had isonatremic dehydration. All the neonates with dehydration fever were successfully treated. No deaths were observed in the present study. Conclusions: Dehydration fever is an important cause of neonatal fever in tropical countries like India, especially during the summer months. The present study highlights the need to be vigilant about dehydration, hypernatremia, and hyperbilirubinemia in breastfed neonates while emphasizing the need to promote exclusive breastfeeding. Dehydration fever can be prevented by educating mothers regarding breastfeeding techniques, beginning in the antenatal period. Those with identifiable problems should be referred promptly for lactation management and supportive counseling.