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How To Treat Low Blood Sugar In Newborn


Does My Baby Have Diabetes

Neonatal Hypoglycemia Causes, Treatment & Prevention

In adults, blood sugar problems are often caused by diabetes. If a mother has diabetes, her baby is more likely to have short-term low blood sugar at birth. The problem continues until the babys pancreas adjusts to his or her normal blood sugar level. But the blood sugar problem your baby has does not mean your baby has diabetes. If your baby has low or high blood sugar as a newborn, it doesn’t mean your baby is likely to grow up to have diabetes, either.

Low Blood Sugar In Newborns Prognosis

The outlook is good for newborns who do not have symptoms or who respond well to treatment. However, low blood sugar level can return in a small number of babies after treatment.

Hypoglycemia is more likely to return when babies are taken off feedings given through a vein before they are fully ready to eat by mouth.

Babies with more severe symptoms are more likely to develop learning problems. This is more often true for babies who are at a lower-than-average weight or whose mother has diabetes.


References

How Is Neonatal Hypoglycemia Treated

The specific type of treatment for hypoglycemia will be determined by a medical professional based upon the following:

  • Your childs gestational age, overall health, and medical history
  • Extent and severity of the condition
  • Your childs ability to tolerate medications, procedures and treatment
  • Expectations for the course of the disease
  • The opinions and preferences of a childs parents

In consideration of the above factors, the most common treatment for NH includes providing an affected child with a rapid-acting form of glucose. This may be as simple as providing the child with a water/glucose mixture or formula, either by mouth or through the use of nasogastric lavage. Under certain circumstances, a baby may need to be administered with glucose intravenously, or IV. Subsequently, the babys blood glucose levels must be monitored closely after treatment to see if the hypoglycemia occurs again.

These forms of treatment normally last up to a week. However, some children may respond positively to treatment within a few hours. If a childs blood sugar remains low, he or she may also receive medication to increase said levels or to reduce the childs insulin production . Occasionally, newborns with severe forms of NH who fail to improve with treatment may require surgery to remove part of the pancreas in order to reduce insulin production.

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How Should We Prevent Low Blood Sugar

  • Diabetes in the mother, particularly type 1 , is a high risk situation for the baby. This is due to the fact that at birth high insulin levels in the baby not only drop the blood sugar but also prevent his bodys formation of ketone bodies, lactic acid, and free fatty acids. Therefore the baby needs to be watched and may require an intravenous to maintain the blood sugar.
  • Good control of diabetes during the pregnancy can help prevent low blood sugar.
  • Good control of diabetes during the labour and birth also is important.
  • We, and postpartum departments all over the world , have suggested to our prenatal patients whose babies are at high risk to express their colostrum before the baby is born, starting at about 35 or 36 weeks gestation. Most can get a few millilitres a day by hand expression and a mother can often get 30 or 40 millilitres saved before the baby is born. If the baby needs to be supplemented to control the blood sugar, the baby is given colostrum, not formula.
  • Intravenous fluids containing glucose given rapidly to the mother should be avoided. If the mothers glucose tolerance is impaired, a lot of glucose given her may increase her blood sugar and provoke a similar response in the baby with a corresponding rise in the babys insulin secretion.
  • Low Blood Sugar In Newborns: Causes Signs And Long

    5. Neonatal Hypoglycemia

    Glucose, or blood sugar, is crucial to brain development as it is the main source of energy for the brain. Neonatal hypoglycemia is a condition in which a babys blood sugar falls dangerously low within a few days of birth. These low glucose levels can impair the growth process and cause brain cells to die. Neonatal hypoglycemia is one of the most common neonatal metabolic issues, and is easily treated.When a baby transitions to life outside the mothers womb, blood glucose levels naturally drop during the first two hours after delivery . However, an infant with neonatal hypoglycemia experiences a more dramatic and prolonged drop in blood sugar than a healthy infant would. In utero, the fetus is usually able to obtain steady glucose levels from the mother through the placenta. After birth, the infant takes in glucose from breastmilk or formula, as well as producing it in the liver. A stable level of glucose is important for organ function in a newborn baby, and the brain uses glucose almost exclusively for energy metabolism and development .

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      Treating Low Blood Sugar

      If there is a concern about the babys blood sugar dropping too rapidly or being too low and good breastfeeding doesnt seem to be correcting the problem, the baby should get an intravenous infusion of glucose rather than formula. Babies often spit up formula in the first few days because they get so much. If there is a real concern, taking formula by mouth does not guarantee the blood sugar will be raised.

      Every postpartum unit should have banked breastmilk available on site. Banked breastmilk is preferable to formula as a supplement whenever the supplement is truly necessary. Even if the baby needs treatment for low blood sugar, there is rarely a reason for the baby not to breastfeed as well. A baby can be at the breast even if he has an intravenous. A baby can get supplements even while being breastfed.

      Symptoms Of A Low Blood Sugar Level

      A low blood sugar level can affect everyone differently. You’ll learn how it makes you feel, although your symptoms may change over time.


      Early signs of a low blood sugar level include:

      • sweating
      • a fast or pounding heartbeat
      • becoming easily irritated, tearful, anxious or moody
      • turning pale

      If a low blood sugar level is not treated, you may get other symptoms, such as:

      • weakness
      • unusual behaviour, slurred speech or clumsiness
      • feeling sleepy
      • seizures or fits
      • collapsing or passing out

      A low blood sugar level, or hypo, can also happen while you’re sleeping. This may cause you to wake up during the night or cause headaches, tiredness or damp sheets in the morning.

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      Low Blood Sugar In Newborns

      Low blood sugar level in newborn babies is also called neonatal hypoglycemia, refers to low blood sugar in the first few days after birth. During an episode of hypoglycemia, theres not enough glucose in the blood. The normal glucose range is approximately 70 to 150 mg/dl . Neonatal hypoglycemia occurs when the newborns glucose level causes symptoms or is below the level considered safe for the babys age. Neonatal hypoglycemia is defined as a plasma glucose level of less than 30 mg/dL in the first 24 hours of life and less than 45 mg/dL thereafter, is the most common metabolic problem in newborns 1). Low blood sugar level in newborn occurs in about 1 to 3 out of every 1,000 births. In the majority of cases, hypoglycemia is temporary, easily treated and usually does not have serious consequences. There are several rare disorders in which hypoglycemia is recurrent and potentially life-threatening. However, with timely diagnosis and appropriate treatment, these can be effectively managed.


      Is Low Blood Sugar In Newborns Common

      The Liggins Institutes Professor Jane Harding on low blood sugar in newborns ONE News, TVNZ

      Approximately about 15% of newborns are suffering from low blood sugar levels called neonatal hypoglycemia in medical terms. And this is the only condition that can be prevented to stop the brain damage in infants. Let us have a look at what causes low blood sugar levels in newborns and how low blood sugar in newborns can be addressed.

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      General Treatments For Neonatal Hypoglycemia

      If IV dextrose isnt an option for a baby with NH, glucagon can be used as a treatment and administered subcutaneously or intramuscularly . Glucagon can be used to treat babies who experience severe hypoglycemia and may not have dextrose available to them. Babies who have experienced NH and are not being treated with dextrose or glucagon should be fed within the first hour of life. These feedings should be done at two to three hour intervals, and blood glucose concentrations should be monitored frequently within 20 to 30 minutes after being fed. Babies who are breastfed may need supplemental formula until the mother is able to produce enough breast milk .

      Drug Treatment For Hypoglycemia In Newborns

      The early treatment of low blood sugar levels in newborns prevents the complications of neurologic damage. Feeding the newborn with breast milk or formula is encouraged to avoid hypoglycemia. The doctors use a nasogastric tube in newborns who are unable to drink breast milk or formula. Many newborns cannot protect their airways or are unable to drink milk. Drugs like dextrose, diazoxide, glucagon, and octreotide are administered to them with the help of IV, nasogastric tube, intramuscular, or intraosseous routes.

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      Diagnosis And Treatment Of Neonatal Hypoglycemia

      When a baby shows clinical signs of having low blood glucose or the baby is known to be at risk for neonatal hypoglycemia, a blood glucose test must be done immediately. This test should be done within minutes of any presented symptoms by sending some of the babys blood to the lab for analysis. If the baby has low blood sugar, then their glucose concentration should be retested every three to six hours within the first 24 to 48 hours of life . Because NH can result in brain injury if not treated properly, it is important to use aggressive therapy that includes the use of a parenteral glucose to increase blood glucose levels in children exhibiting symptoms . Dextrose is typically administered through an IV and the levels are monitored and adjusted until the blood glucose level in the baby is at an acceptable concentration. If needed, treatment will be continued for a few hours or days to a week, or until the baby can maintain normal glucose levels. Babies who were born early, have an infection, or were born at a low weight may need to be treated for a longer period of time.

      How Can Parents Help

      Neonatal Hypoglycemia: Symptoms, Causes, and Diagnosis

      Nearly every child with diabetes will have an episode of hypoglycemia at times. You can help make this less likely, and be ready if it does happen. Here are some tips:

      • Follow your childs diabetes care plan. This is the best way to keep their sugars in a healthy range. The plan will guide you on the timing of:
      • meals
      • exercise
      • blood sugar checks
    • Have your child avoid baths or hot showers right before and after an insulin shot. Ask your care team how long your child should wait.
    • Track and adjust sugar levels before and during exercise. And make sure your child eats snacks as needed to keep or bring blood sugar levels into the healthy range.
    • Keep sugar handy and give it to your child right away if they have symptoms.
    • Teach adult family members, caregivers, and school staff the signs of hypoglycemia, when and how to give glucagon, and when to get emergency medical care.
    • Get your child a medical ID. Your child should wear or carry identification stating they have diabetes and includes who to contact in case of an emergency.
    • If you have questions about how to prevent or treat hypoglycemia, or about the diabetes care plan, call your child’s diabetes health care team.

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      Signs And Symptoms Of Hypoglycemia In Newborn

      Newborns with low blood sugar in the first or second day may not have symptoms or may have life-threatening central nervous system and cardiopulmonary disturbances.


      Symptoms of low blood sugar in babies can include the following:

      • Hypotonia
      • Problems keeping the body warm
      • Tremors, shakiness, sweating, or seizures

      Infants in the first or second day of life may be asymptomatic .

      Why Do Some Babies Have Low Blood Glucose

      • In healthy full-term babies , blood glucose levels are at their lowest 1 to 2 hours after birth. After this, the levels usually start to rise as your babys body starts to use healthy sugar and fat stores.
      • Small and preterm babies may not have enough stores to keep the level up without extra feedings. These babies are most at risk for low blood glucose in the first 24 hours of life.
      • Babies whose mothers have diabetes may have trouble using their glucose stores. The normal rise in blood sugar that takes place after birth may not happen right away.
      • Babies who are large for their gestational age may have the same kind of problem during the first 12 hours of life.

      Usually, low blood glucose levels will only last for a few hours, but can last up to 24-72 hours. Once your babys levels become normal, he shouldnt have further problems with hypoglycemia .

      In very rare cases, low blood sugar can be severe or last a long time. If this happens, your doctor will do special tests to look for other causes.

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      What Do I Do If My Baby Has Low Blood Glucose Levels

      Your baby will be checked for signs of illness. He will need extra feedings if his levels dont rise on their own. The extra feeds can be given:

      • from the breast,
      • as expressed breast milk, or
      • as formula.

      If the extra feedings dont raise the blood glucose level, glucose gel can be provided with a feed to raise the blood sugar. This can be repeated once, but if your babys blood sugar remains low or if your baby is not able to feed well, they will need intravenous treatment . Preterm babies or babies with low birth weight often have an intravenous started when they are born.

      Where Do Babies Get Glucose

      Hypoglycemia in Neonates

      Babies get glucose through the placenta and umbilical cord while in their mothers uterus . Some of that glucose is used right away as energy and some is stored for after birth. This stored glucose helps keep your babys levels normal for the first few days of life until she is feeding well.

      Once moms breast milk is established , it becomes the main source of sugar for your baby. The sugar in milk changes to glucose in the body. When this happens, your baby will also start to store glucose for use between feeds.

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      Low Blood Sugar In Babies Prevention

      If you have diabetes during pregnancy, work with your healthcare provider to control your blood sugar level. Be sure that your newborns blood sugar level is monitored after birth. A study by Joshi et al 2) suggested that in women with pregestational type 1 or type 2 diabetes, neonatal hypoglycemia can be avoided by aiming at an intrapartum blood glucose level of 72 126 mg/dl .

      How Is Neonatal Hypoglycemia Diagnosed

      If a child is suspected as having NH, there are a number of ways in which a medical professional can identify and confirm a diagnosis of the condition. These are:

      • Blood test A simple blood test that analyzes blood glucose levels can readily diagnose a case of NH. Specifically, a medical professional can draw blood from a child through the use of a heel stick, from the babys arm, or through a device known as an umbilical catheter .
      • Urinalysis A urine test can also detect whether a child has neonatal hypoglycemia.

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      When Blood Sugar Is Too Low

      Hypoglycemia is the medical word for low blood sugar level. It needs to be treated right away. Why? Because glucose, or sugar, is the body’s main fuel source. That means your body including your brain needs glucose to work properly.

      When blood sugar levels go lower than they’re supposed to, you can get very sick. Your parents and your diabetes health care team will tell you what your blood sugar levels should be and what to do if they get too low.


      How To Diagnose Low Blood Sugar In Newborns

      how to treat low blood sugar in newborn

      Newborns will have blood tests to know the sugar level for a few hours. A heel stick is used for this. The healthcare professionals will keep continuing the test until the glucose level comes to normal for nearly 12 to 24 hours.

      Some other tests may include screening for metabolic disorders and urine tests.

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      Preventing A Low Blood Sugar Level

      If you have diabetes, you can reduce your chance of getting a low blood sugar level if you:

      • Check your blood sugar level regularly and be aware of the symptoms of a low blood sugar level so you can treat it quickly.
      • Always carry a sugary snack or drink with you, such as glucose tablets, a carton of fruit juice or some sweets. If you have a glucagon injection kit, always keep it with you.
      • Do not skip meals.
      • Be careful when drinking alcohol. Do not drink large amounts, check your blood sugar level regularly, and eat a carbohydrate snack afterwards.
      • Be careful when exercising eating a carbohydrate snack before exercise can help to reduce the risk of a hypo. If you take some types of diabetes medicine, your doctor may recommend you take a lower dose before or after doing intense exercise.
      • Have a carbohydrate snack, such as toast, if your blood sugar level drops too low while you’re asleep

      If you keep getting a low blood sugar level, talk to your diabetes care team about things you can do to help prevent it.


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