Question: My 2 week old is in the hospital and the doctors told me to put salt in her bottle to replace her lost salt. The baby has been gagging and crying every time she eats. Is there another way to do this? Is there a pill we could crush up and put in a syringe and squirt in her mouth like they were doing with another medicine?

I’ve tried the bottle but it was like drinking the ocean. The doctors are encouraging me not to breastfeed.

A: You should definitely breast feed if you want to!

If your baby is rejecting the salt, then it’s possible that she is not a salt-waster or perhaps doesn’t need as much salt as you are giving her. Babies who are salt-wasters need and crave salt — they generally gobble up salt like it’s candy! If she does need salt supplementation, then sodium chloride (NaCl) comes in 1 gram tablets (by prescription) that are easily dissolvable in water. Depending on how much sodium your doctor wants her to get per day (the usual amount for an infant with salt-wasting CAH is 1-2 grams per day), you can dissolve the total amount in water and then divide it into 3-4 doses given by syringe. I would not recommend putting it in her bottle because then she won’t want to eat anything! You can start with 1 gram of NaCl (one tablet) and dissolve it in 15 mL of water, then give her 5 mL by syringe three times a day. Or, if that is still too salty, you can dissolve it in 30 mL of water and give her 10 mL by syringe three times a day. If necessary, you can try to add a little glucose to the solution so it doesn’t taste as salty, but you should ask your doctor about that.