Neonatal diarrhea in a diarrhea treatment center in Bangladesh: clinical presentation, breastfeeding management and outcome.

A prospective study was conducted to study the clinical presentation and outcome of neonates admitted with diarrhea and effect of counseling their mothers for exclusive breast-feeding. 244 neonates in an in-patient unit were studied during 1994-95. Their mean (SD) age was 18 (6.2) days and body weight and length were 2.18 (0.52) kg and 47.5 (3.2) cm respectively. More neonates had some dehydration than severe dehydration (78% vs. 11%) with mean (SD) serum bicarbonate values 9.6 (5.1) mmol/1. Vibrio cholerae was isolated from 25 (12%) Shigella spp. from 8 (3%) and Salmonella spp. from 3 (1%) of the patients who had rectal swab cultures. Mean (SD) hospital stay was 3.6 (2.1) days during which the majority (80%) recovered fully but 29 (13%) left earlier. 11 (4%) of the neonates had to be referred elsewhere for treatment of other problems and 7 (3%) died. None of the neonates were exclusively breastfed on admission. Excluding mothers of adopted neonates breast-feeding counseling enabled 64% of the mothers to convert to exclusive breast-feeding during the hospital stay. Most of the neonates admitted with diarrhea were small and underweight and had poor feeding practices. The majority of neonates recovered soon and were exclusively breastfeeding when discharged from the hospital. Breast-feeding counseling should be included as an integral part of case management at all health facilities. (authors)