Nothing's scarier than having a sick child, and one so newly born, and so vulnerable. It's the worst thing for a parent - Kenneth Oppel, The Nest
image by: Ahmed Ghieth
For over half a century, neonatal hypoglycemia has been a contentious topic. Although there is agreement that recurrent severe hypoglycemia causes brain injury, there have been few high-quality studies providing data that inform the management or report the neurodevelopmental outcomes of transient neonatal hypoglycemia. Much of the controversy about neonatal hypoglycemia has focused on the question of number — that is, What glucose level should be used to “define” hypoglycemia in neonates?
Because the validity of statistical definitions of neonatal hypoglycemia has been appropriately criticized, an alternative approach has been to evaluate long-term outcomes, such as those in the recent…
Much of the controversy about neonatal hypoglycemia has focused on the question of number — that is, What glucose level should be used to “define” hypoglycemia in neonates?
Congenital Hyperinsulinism (HI) is the most frequent cause of severe, persistent hypoglycemia in newborn babies and children. In most countries it occurs in approximately 1/25,000 to 1/50,000 births. About 60% of babies with hyperinsulinism develop hypoglycemia during the first month of life.
What every practitioner needs to know about Neonatal Hypoglycemia.
In term infants who have asymptomatic mild hypoglycemia, an initial attempt at enteral feeding may be successful in reaching target blood glucose values. It is estimated that blood glucose concentrations should increase by approximately 1.67 mmol/L (30 mg/dL) within the first hour after a feeding of 30 to 60 mL of standard infant formula.
•Glucometer reading: (a) <20 mg/dL or (b) <40 mg/dL and NPO or preterm or (c) <40 mg/dL after feeding or (d) <40 mg/dL and symptomatic -Draw blood for stat glucose measurement. -Give IV bolus of 2-3 mL/kg of D10W. -Begin continuous infusion of D10W at 4-6 mg/kg/min. -If infant of diabetic mother, begin D10W at 8-10 mg/kg/min (100-125 cc/kg/d). -Repeat blood glucose in 20 min and pursue treatment until blood sugar >40 mg/dL
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