Hypoglycemia

Newborns may have a finger or heel stick blood glucose level obtained during transition. Certain conditions including large infants, small infants, premature infants, babies born to mothers with diabetes (or abnormal glucose tolerance test during pregnancy), or jittery babies may require more testing. Normal values ( >35 during the first four hours, >45 during four to 24 hours, and >50 after 24 hours of life) will assure a stable neurologic condition. 

Early treatments include: 

Glucose gel - A concentrated glucose paste can be placed in the baby's mouth under the tongue to boost glucose levels. Gel can be given up to three times if glucose values are low. 

 Early Feedings - Babies are encouraged to feed on the breast immediately after vaginal birth. The concentrated colostrum boosts their blood glucose level. Babies delivered by cesarean birth may have a delay before mom reaches the recovery room. If blood glucose value is very low and the baby doesn't respond to glucose gel, a formula feeding may be necessary. 

 Supplemental Feedings - Sometimes  breast feeding can be supplemented with either donor breast milk or formula if glucose values are low. The formula should be either a standard newborn formula such as Similac Advance or Neosure formula. Glucose values normally stabilize by the time the mother's milk comes in. 

Newborns that cannot maintain a glucose level in the normal range despite using the above treatments may need IV fluids such as Dextrose in the NICU. Matching the amount of glucose needed with Dextrose removes the potential for harm due to low blood sugars. By weaning the IV fluids, the baby's blood sugar slowly normalizes.