What is Hypoglycaemia?

Sugar (glucose) is an essential source of energy in the body. Blood sugar levels fall after birth and if allowed to fall too low may may cause brain injury or other problems. Low blood sugar (called hypoglycaemia) is said to occur when blood glucose levels fall to lower than 30 mg/dL (Milligram per Deciliter) (1.65 mmol/L (milimoles per Liter)) in the first 24 hours after birth or less than 45 mg/dL (2.5 mmol/L) thereafter. Mild hypoglycaemia can be asymptomatic in the first one or two days.

Who is affected and what are the risk factors?

Hypoglycaemia is one of the most common symptoms in newborn babies. Babies who are born preterm, small for gestational age, or following diabetes in the mother are at higher risk of developing this condition.

What is the cause?

Causes of hypoglycaemia include limited stores of glycogen (can be converted to glucose), and increased glucose need. This occurs in the three conditions above and also may occur with infection or if the baby’s body temperature drops.  There are many other rarer causes of low blood sugar which the doctor will test for if the problem does not resolve quickly or there are no other risk factors.

How is it diagnosed?

Symptoms, which can be detected by the healthcare team include a low muscle tone (hypotonia), lethargy or apathy, poor feeding, blue or purple colour of the skin (cyanosis), apnoe, low body temperature (hypothermia), and seizure.

Usually, infants at risk for hypoglycemia are screened after birth by measuring blood sugar level. A nurse, midwife or doctor takes a small blood sample from the heel of the baby, from the vein, or from an intravenous catheter that does not have glucose infusing in it.  This sample can be analysed by either using a specific device to test blood sugar level (also called glucose meter) or lab analysis. Sometimes this screening is repeated in regular time intervals during the first hours or days, depending on the overall health condition of the baby.

How is it managed?

If hypoglycaemia persists despite oral feeding or is associated with severe symptoms, the medical team can give extra glucose orally or intravenously by giving a fluid containing glucose (usually, 5% or 10%) to stabilise the blood glucose level. The administration of glucose depends on the health situation of the baby.

© 2018 EFCNI - European Foundation for the Care of Newborn Infants
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