Characteristics of hypoglycemia in the newborn. One of the most common metabolic problems in the newborn, hypoglycemia,is characterized by low blood sugar levels in the first few days after birth. A plasma or blood glucose level of less than 30 mg/dL (1.65 mmol/L) in the first 24 hours of life and less than 45 mg/dL (2.5 mmol/L) thereafter causes hypoglycemia in the newborn.
Causes of hypoglycemia.
Causes of hypoglycemia in new born babies differ slightly from the causes of hypoglycemia in older babies. Babies need sugar (glucose) for energy and the optimum levels of glucose are maintained by a process called gluconeogenesis which is brought about by insulin secreted by the pancreas.
Highlevel of Insulin.. If there is high level of insulin or hyperinsulinimia,gluconeogenesis does not happen, leading to a low blood glucose level in the newborn. This happens mostly to those babies whose mothers have been identified with having diabetes.
Screening for hypoglycemia. Screening for hypoglycemia is recommended in the following scenarios: clickable format
? Low birth weight infants (<1500 grams)
? Preterm infants (< 35 weeks)
? Small for gestational age infants (SGA) with birth weight <10th percentile
? Infant of diabetic mother (insulin dependent and gestational diabetes)
? Large for gestational age (LGA) infants with birth weight >90th percentile
? Infants with Rh-hemolytic disease
? Infants born to mothers receiving therapy with hypoglycemic drugs
? Neonates with perinatal asphyxia, polycythemia, sepsis, shock, respiratory distress, hypothermia
? Infants with morphological growth retardation; this group includes neonates with a birth weight between 10th – 90th percentile with features of foetal under-nutrition in the form of skin peeling, loose skin folds and deficient buccal pad of fat
? Infants on intravenous fluids and total parenteral nutrition
Gestational age babies must not be screened. However, screening for hypoglycemia is not recommended in term breast-fed appropriate for gestational age (AGA) babies. Term babies with poor feeding, presence of inadequate lactation or presence of stress must be screened for hypoglycemia.
Symptoms of hypoglycemia in newborns.
Sometimes new born babies with hypoglycemia may not show any signs of having hypoglycemia. However, in most instances they do show some signs.
Apathy, lethargy and/ Or vomiting. babies may show signs of pathy, lethargy, irritability, cyanosis, vomiting, hypotonia weak or high pitched cry, seizures, diminished oral intake, altered levels of consciousness, and unresponsiveness.
Cures for hypoglycemia.
Breast feeding, intravenous glucose feed and medication can cure hypoglycemia.
Breast feeding. For instance, infants with hypoglycemia can do well with feeding with breast milk within the first few hours after birth, either by mouth or through a tube inserted into the stomach.
Intravenous glucose feed. If your baby is unable to feed by mouth or if her blood sugar level is very low, she might need to be treated through intravenous glucose feed. This treatment normally continues for a few hours or days to a week.
Medication. If the low blood sugar continues, the baby may also receive medication to increase blood glucose levels or decrease insulin production.
Don’t worry, hypoglycemia is perfectly curable. They key to it is being watchful and alert. What is needed is an efficient co-ordination between the parents and the medical staff around. Once the baby gains the normal levels of blood glucose, just be a bit extra careful with her so that she maintains the same optimum level.