Infant surgery

Infant electrolytes

Pyloric stenosis

Older children

Specific losses

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All healthy newborn infants are expected to lose approx. 10% of their birthweight during the first week of life. They regulate this themselves with their oral intake. When patients are NPO and we are responsible for their fluid management, we still need to keep expected physiologic processes in mind. Most non-surgical neonates on IV fluids therefore receive a graduated regimen of IVF. Typically, the expected fluid needs are:

Day#1: 60ml/kg/day

Day#2: 80ml/kg/day

Day#3: 100ml/kg/day

Thereafter 100-150 ml/kg/day.

Summary of neonatal fluid management:

1. establish state of hydration to determine volume and rates

2. establish source of fluid losses to determine electrolyte needs

3. fluid boluses are frequently necessary, but beware of inducing shunting.

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