{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:34:43Z","timestamp":1787009683177,"version":"build-2736575974"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hyperosmolar-hypernatremic dehydration (HHND) is a life-threatening yet preventable neonatal condition, often due to inadequate breastfeeding. The recent North Indian heat wave heightened dehydration risks, necessitating an evaluation of extreme temperatures\u2019 impact on neonatal hydration. This retrospective study analysed neonates admitted to a tertiary care level 3 neonatal intensive care unit (NICU) at AIIMS Jodhpur between April and June 2024. Case records were reviewed, and details on maternal age, feeding practices, presenting complaints, biochemical profile, and outcome were studied. The 2024 (April\u2013May) heat wave led to a threefold increase in NICU admissions for HND compared to the previous 2 years, with cases rising from 2 to 3 per year to 10. Primigravida mothers accounted for 70% of the cases. The mean age of presentation was 6.7\u2009days. Affected neonates experienced weight loss ranging from 11% to 33%, with serum sodium levels between 149 and 185 mEq\/l and plasma osmolarity reaching 370\u2013450 mOsm\/l. Six neonates required peritoneal dialysis (PD) due to encephalopathy\/anuria. One developed aortic thrombosis with lower limb gangrene, necessitating thrombolytic therapy. MRI abnormalities were observed in one case. Despite intensive management, one neonate succumbed to sepsis. Extreme environmental heat significantly heightens the risk of hyperosmolar-hypernatremic dehydration (HND) in neonates. Proactive neonatal monitoring, early breastfeeding support, and parental education are critical to preventing dehydration and its complications, especially in tropical and resource-limited settings, where extreme heat, early discharge, and limited lactation support increase neonatal vulnerability. Judicious fluid management targeting plasma osmolarity and timely intervention with PD in severe cases can optimize survival and neurological outcomes, underscoring the need for heightened vigilance during heat waves.<\/jats:p>","DOI":"10.1093\/tropej\/fmag028","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T12:46:24Z","timestamp":1774701984000},"source":"Crossref","is-referenced-by-count":1,"title":["A growing crisis of neonatal hyperosmolar-hypernatremic dehydration during heat waves: clinical insights from a semi-arid region"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1465-4203","authenticated-orcid":false,"given":"Swasthi","family":"Kabi Satpathy","sequence":"first","affiliation":[{"name":"Department of Neonatology, All India Institute of Medical Sciences , Basni Phase II , Jodhpur 342005, Rajasthan,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6292-110X","authenticated-orcid":false,"given":"Choudri Muzafar","family":"Paswal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, All India Institute of Medical Sciences , Basni Phase II , Jodhpur 342005, Rajasthan,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Kumarendu","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neonatology, All India Institute of Medical Sciences , Basni Phase II , Jodhpur 342005, Rajasthan,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Neonatology, All India Institute of Medical Sciences , Basni Phase II , Jodhpur 342005, Rajasthan,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8456-1133","authenticated-orcid":false,"given":"Sushil Kumar","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Neonatology, All India Institute of Medical Sciences , Basni Phase II , Jodhpur 342005, Rajasthan,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"2026050113311897200_fmag028-B1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/0890334415613079","article-title":"Breastfeeding-associated hypernatremia: asystematic review of the literature","volume":"32","author":"Lavagno","year":"2016","journal-title":"J Hum Lact"},{"key":"2026050113311897200_fmag028-B2","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1007\/s13312-024-3134-z","article-title":"Impact of seasonal variation in temperature on dehydration in neonates","volume":"61","author":"Krishnegowda","year":"2024","journal-title":"Indian Pediatr"},{"key":"2026050113311897200_fmag028-B3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/BF02758258","article-title":"Dehydration and hypernatremia in breast-fed term healthy neonates","volume":"73","author":"Bhat","year":"2006","journal-title":"Indian J Pediatr"},{"key":"2026050113311897200_fmag028-B4","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.18203\/2349-3291.ijcp20182565","article-title":"Maternal factors and feeding pattern in neonates admitted with dehydration","volume":"5","author":"Goyal","year":"2018","journal-title":"Int J Contemp Pediatr"},{"key":"2026050113311897200_fmag028-B5","author":"Donthamsetty","year":"2018"},{"key":"2026050113311897200_fmag028-B6","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4103\/0972-5229.198323","article-title":"Hypernatremia in the neonate: neonatal hypernatremia and hypernatremic dehydration in neonates receiving exclusive breastfeeding","volume":"21","author":"Mujawar","year":"2017","journal-title":"Indian J Crit Care Med"},{"key":"2026050113311897200_fmag028-B7","doi-asserted-by":"crossref","first-page":"436","DOI":"10.18203\/2349-3291.ijcp20190227","article-title":"Clinical profile of neonates admitted with hypernatremia in NICU at tertiary hospital in Vadodara, Gujarat, India","volume":"6","author":"Pandya","year":"2019","journal-title":"Int J Contemp Pediatr"},{"key":"2026050113311897200_fmag028-B8","doi-asserted-by":"crossref","first-page":"512","DOI":"10.32677\/IJCH.2019.v06.i09.011","article-title":"Hypernatremia in exclusively breastfed term neonates","volume":"6","author":"Trivedi","year":"2019","journal-title":"Indian J Child Health"},{"key":"2026050113311897200_fmag028-B9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/00000433-199803000-00003","article-title":"Fatal hypernatremic dehydration in exclusively breast-fed newborn infants due to maternal lactation failure","volume":"19","author":"Kaplan","year":"1998","journal-title":"Am J Forensic Med Pathol"},{"key":"2026050113311897200_fmag028-B10","first-page":"38","article-title":"Risk factors and neurological outcomes of neonatal hypernatremia","volume":"8","author":"Kamrani","year":"2017","journal-title":"Iran J Neonatol"},{"key":"2026050113311897200_fmag028-B11","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1089\/bfm.2016.0054","article-title":"Long-term neurodevelopmental outcome of neonates with hypernatremic dehydration","volume":"12","author":"Boskabadi","year":"2017","journal-title":"Breastfeed Med"},{"key":"2026050113311897200_fmag028-B12","doi-asserted-by":"crossref","first-page":"153","DOI":"10.4103\/2249-4847.140402","article-title":"Complications due to breastfeeding associated hypernatremic dehydration","volume":"3","author":"Ahmed","year":"2014","journal-title":"J Clin Neonatol"}],"container-title":["Journal of Tropical 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