hypoglycaemia of the newborn

Last edited 04/2022 and last reviewed 09/2022

Hypoglycaemia of the newborn is defined as a blood glucose of less than 2.5 mmol per litre. It occurs in 0.4% of all births, but is much more common in infants of diabetic mothers - previously diagnosed diabetics or gestational diabetics - and in low birth weight and premature infants.

Neonatal hypoglycaemia is a common condition that can be associated with brain injury

• clinical management usually includes early identification of at-risk infants (e.g. infants of diabetic mothers; preterm, small- or large -for -gestational -age infants), and prophylactic measures are advised. However, these measures usually involve use of formula milk or admission to the neonatal unit
  
  
• dextrose gel is non-invasive, inexpensive and effective for treatment of neonatal hypoglycaemia
  • prophylactic dextrose gel can reduce the incidence of neonatal hypoglycaemia, thus potentially reducing separation of mother and baby and supporting breastfeeding, as well as preventing brain injury
  • a concludes oral dextrose gel reduces risk of neonatal hypoglycaemia in at -risk infants and probably reduces risk of major neurological disability at >= 2 years of age without increasing the risk of adverse events compared to placebo gel (1)
• a systematic review found oral dextrose gel (specifically 40% concentration) used to treat hypoglycaemia in newborn infants probably increases correction of hypoglycaemic events & may result in a slight reduction in the risk of major neurological disability at age >= 2 years (2)

Reference:

• Edwards T, Liu G, Hegarty JE, Crowther CA, Alsweiler J, Harding JE. Oral dextrose gel to prevent hypoglycaemia in at-risk neonates. Cochrane Database of Systematic Reviews 2021, Issue 5. Art. No.: CD012152. DOI: 10.1002/14651858.CD012152.pub3. Accessed 09 December 2021.
• Edwards T, Liu G, Battin M, Harris DL, Hegarty JE, Weston PJ, Harding JE. Oral dextrose gel for the treatment of hypoglycaemia in newborn infants. Cochrane Database of Systematic Reviews 2022, Issue 3. Art. No.: CD011027. DOI: 10.1002/14651858.CD011027.pub3.