OBJECTIVE: The objective of this paper was to provide a literature review on hypernatremic dehydration (HND) in children and the role of Charts, which are based on weight loss with Standard Deviation Score (SDS), in its management. Before this condition can be treated, it is important to assess the weight loss by the patient. Charts based on weight loss with SDS have been established by a case-control study to diagnose HND. The vast majority of children with already present or developing HND fell below the -1 SDS line at day 3, the -2 SDS line at day 4, and the -2.5 SDS line at day 5. Therefore, charts for weight loss can be helpful in early diagnosis of HND and in its prompt management plan. ----- METHODS: The key terms of hypernatremic dehydration in children, management of hypernatremic dehydration and breast-feeding were searched on Pubmed and the literature available under these terms was reviewed and summarized in this paper, and a clinical case is presented to demonstrate HND due to problem in initiation of breastfeeding. ----- DISCUSSION: The problem of HND is recurrent in the hospital setting but also represents a common issue in breastfed infants. It is normal over the 1st week of life for the neonate to lose as much as 7% of its birth weight through normal diuresis, but then should start to gain weight thereafter. Rapid weight loss > 7% of birth weight is the most obvious sign of neonatal dehydration due to HND with symptoms of decreased bowel movements, decreased urination, dry mucous membranes, sunken fontanel, poor skin turgor, and lethargy. Therefore, routine weight monitoring is universally proposed for the early detection and management of HND. The poor initiation of breastfeeding can lead to development of HND in infants, which besides the clinical assessment of the newborn also requires the educational preventive measures. ----- CONCLUSION: The monitoring of weight loss in children along with clinical presentation can help in diagnosis of HND, and subsequently proper management. To avoid serious morbidity and mortality, all breastfed infants should receive regular follow-up by health-care workers.