Sir.—We recently treated three children with water intoxication who were receiving evaporated milk formula. During that same period (1985 to 1989), there were 14 instances of admissions to our institution for water intoxication, which we have already noted as having become more frequent than in the recent past. 1 Ordinarily, one would expect infants receiving evaporated milk formulas to be vulnerable to hypernatremia.2 We tried to find a reason for this unexpected outcome.
In each instance, the problem was related to improper feeding practices. The mothers, all of whom were participants in the Women, Infants, Children (WIC) program at our institution, were either excessively diluting the milk or using small amounts of properly reconstituted evaporated milk to supplement larger quantities of relatively electrolyte-free fluids such as diluted fruit juices or water.
The parents of the infants enrolled in the WIC program are carefully instructed in the proper use
SCHAEFFER AV, DITCHEK S. Current Social Practices Leading to Water Intoxication in Infants. Am J Dis Child. 1991;145(1):27-28. doi:10.1001/archpedi.1991.02160010029006