ELECTROLYTE IMBALANCES IN PEDIATRIC DIARRHEA: COMPARATIVE ANALYSIS OF BREASTFEEDING AND OTHER FEEDING PRACTICES

Abstract

Background: Diarrheal disease is a leading cause of morbidity and mortality in children under five. Feeding practices may influence the incidence and severity of diarrheal complications, including electrolyte disturbances.

Objective: To compare the frequency and types of electrolyte imbalances in children under five with acute diarrhea according to feeding practice: exclusive breastfeeding versus other feeding (formula, cow’s milk, mixed).

Methods: This cross-sectional observational study enrolled 100 children (1 month–5 years) presenting with acute diarrhea to the pediatric unit of a tertiatycentre between December 2020 and December 2022 Clinical dehydration status, feeding history, and laboratory tests (serum Na⁺, K⁺, Cl⁻, blood glucose, renal function) were recorded. Participants were grouped into: [1] Breastfeeding (exclusive breastfeeding) and [2] Other feeding (formula, cow’s milk, mixed). Data were analyzed using SPSS v21. Proportions were compared and p < 0.05 was considered statistically significant.

Results: Mean age was 24.04 ± 19.17 months (median 18.17 months; IQR 90–365); 58% male. Feeding distribution: 49% breastfed, 51% other feeding. Dehydration: none 38%, some 54%, severe 8%. Overall electrolyte disturbances: hyperkalemia 30%, hyponatremia 19%, hypokalemia 13%, hypernatremia 12%, elevated chloride 1%. Sodium distribution did not differ significantly between groups. Hypokalemia was significantly more frequent in the other feeding group (216%) than in the breastfeeding group (41%) (p < 0.05).

Conclusions: Exclusive breastfeeding was associated with a lower prevalence of hypokalemia in children presenting with acute diarrhea. No significant relationship was observed between feeding type and sodium or chloride abnormalities. These findings support continued promotion of exclusive breastfeeding as a protective measure against certain electrolyte disturbances.