Neonatal hypoglycemia

1. 8. NEONATAL HYPOGLYCEMIA
By Eyayalem M

2. NEONATAL HYPOGLYCEMIA
– It is when the neonate's blood glucose concentration
is much lower than the average for infants of the
same age and weight.
– Hypoglycemia is indicated when serum glucose
concentrations are:-
• < 35mg/dl in the first 72 hours of life.
• < 45 mg/dl in normal full term neonates.
• < 25 mg/dl in low birth weight neonates.
– Two determinations are necessary to diagnose
hypoglycemia, because blood glucose levels fluctuate
widely.

3. Neonates at risk of developing
hypoglycemia
• Those of low birth weight due to fetal
malnutrition that result in lowered amounts of
body fat and hepatic glycogen stores.
– those who are small for gestational age &
– those whose placentas were abnormal or whose
mothers had toxemia
• those having hyperinsulinism due to maternal
diabetes those who are very ill or immature
whose increased metabolic needs are greater
than their glycogen stores and
• those who have rare genetic or metabolic defects
such as glycogen storage disease .

4. Assessment
• the clinical manifestations
of hypoglycemia that
appear between 24 and 72
hours of age[or sooner]
include:
– jitteriness or tremors
– cyanotic episodes
– lethargy, convulsions
– rapid and irregular
respirations
– periods of apnea
– high pitched or weak cry
– limpness
– upward rolling of eyes
– feeding difficulties
– These neonates may also
periodically perspire, become
pale abruptly, and have low
body temperature
– Symptoms may be transient or
recurrent
– Cardiac failure and arrest may
occur
– If glucose is given, the blood
sugar level rises. If it doesn't,
another diagnosis should be
sought.
– The blood glucose level can be
determined by a Dextrostix
test.

5. Management
– The amount of glucose and the rate at which it is
given IV may vary.
– If the neonate is symptomatic, 2-4 ml/kg of a 25%
glucose solution is given over a period of 10
minutes for immediate relief of symptoms,
followed by IV fluid that delivers glucose at 4-8
mg/kg/minute.
– If the symptoms are not eliminated, hydrocortisone
or prednisolone may be given.
– When the infant's blood sugar has stabilized within
the normal range and oral feedings are tolerated,
IV therapy can be discontinued.

6. Prevention
– Early feeding of newborns after birth.
– Providing a warm environment.
– Any respiratory difficulty should be reported and
alleviated.

7. So Take a Deep Breath and
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