Sodium supplementation in neonates with pierre robin sequence significantly improves weight gain if urinary sodium is low.

Objective: To investigate whether sodium supplementation increases weight gain in babies with grade 3 Pierre Robin sequence if their urinary sodium is low.

Design: Retrospective review of all medical, dietitian, and nursing notes of babies admitted from 2000 to 2007, inclusive.

Setting: Tertiary center for cleft care.

Patients: A total of 33 babies requiring nasogastric and nasopharangeal intubation for Pierre Robin sequence were identified. Those for whom weights could not be measured accurately (n  =  4) were excluded from further study.

Interventions: Urinary sodium was low and weight gain poor in 21 of the remaining 29 babies (72%), and oral sodium supplementation was given to establish and maintain a normal urinary sodium (10 to 20 mmol/L).

Main Outcome Measure: Mean daily weight gain.

Results: The mean daily weight gain of the 18 babies with low urinary sodium admitted in the first few days of life improved from 20 to 34 g (p < .001) following oral sodium supplementation. This gave a mean difference of 14 g (lower quartile  =  6 g, upper quartile  =  25 g, 95% confidence interval  =  20, 90% confidence interval  =  10). The mean daily weight gain of the eight patients who did not require sodium supplementation was 33.6 g.

Conclusions: Urinary sodium tests are simple and noninvasive and allow monitoring of urinary sodium. If low, adequate supplementation improved weight gain (p < .001), reversing failure to thrive in babies with severe Pierre Robin sequence. These findings have been unreported previously.