ArticlesFatal Hypernatremic Dehydration in Exclusively Breast-Fed Newborn Infants Due To Maternal Lactation FailureKaplan, James A. M.D.; Siegler, Richard W. M.D.; Schmunk, Gregory A. M.D.Author Information From the New Hampshire State Medical Examiner's Office, Concord, and Department of Pathology, Dartmouth Medical School, Hanover, New Hampshire (J.A.K.); Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (R.W.S.); and Brown County Medical Examiner's Office, Green Bay, Wisconsin (G.A.S.), U.S.A. Received January 17, 1997; accepted January 31, 1997. Address correspondence and reprint requests to Dr. James A. Kaplan, Office of the Chief Medical Examiner, 250 Pleasant Street, Concord, NH 03301, U.S.A. The American Journal of Forensic Medicine and Pathology: March 1998 - Volume 19 - Issue 1 - p 19-22 Buy Abstract Infants who die of hypernatremic dehydration usually demonstrate at autopsy an underlying condition or disease process that predisposes to increased water loss. In the absence of such findings, forensic concerns may focus sharply on parental or caretaker neglect as an underlying cause of death. In this case report, we describe unrecognized fatal hypernatremic dehydration in two exclusively breast-fed neonates due solely to failure of maternal lactation. We further describe epidemiologic and etiologic features of such deaths and discuss forensic difficulties encountered in their certification. © Lippincott-Raven Publishers.