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Neonatal Hypoglycemia : Causes, Sign, Symptoms, & Treatment

Neonatal Hypoglycemia : Definition, Etiology, Guidelines, Protocol, Pathophysiology, Clinical Features, Care Plan, Management, Ppt

Definition

  • Neonatal Hypoglycemia is defined when random blood glucose level is < 40 mg/dl in a neonate (If plasma glucose is considered then it is < 45 mg/dl).
  • According to WHO newer definition, Neonatal Hypoglycemia is defined when random whole blood glucose level is < 45 mg/dl in a neonate.

Causes

1. Inadequate substrate

e.g.

  • Delayed feeding
  • Inadequate feeding
  • Low birth weight
  • Preterm
  • IUGR (Intrauterine growth restriction)

2. Increased utilisation (Neonatal hyperinsulinemia)

e.g.

  • Infant of diabetic mother
  • Rh- incompatibility
  • Beckwith-Wiedemann syndrome

3. Miscellaneous

  • Sepsis
  • Asphyxia
  • Polycythemia
  • Metabolic disorders like Hypocortisolism, Glycogen storage disease 1

Clinical Features

Asymptomatic

If symptomatic

  • Jitteriness
  • Seizures
  • Coma
  • Apnea
  • Lethargy
  • Bradycardia etc.

** If prolonged Hypoglycemia ⇒ Occipital Lobe Damage

Treatment

A. Asymptomatic

If blood glucose 20-45 mg/dl

Trial of oral food

Recheck in 30 minutes

Still hypoglycemia?

⇓Yes

IV Dextrose infusion (at rate of 6 mg/kg/min.)

If blood glucose <20 mg/dl

  • IV Dextrose infusion (at rate of 6 mg/kg/min.)

B. Symptomatic

IV Dextrose bolus (10% Dextrose 2 ml/kg IV)

IV Dextrose infusion (at rate of 6 mg/kg/min.)

Follow up

  • At 1 month corrected age ⇒ Assessed for vision
  • At 3, 6, 12, & 18 months corrected age ⇒ Assessed for vision, hearing loss, growth, & neurodevelopment.

Prevention

All high risk babies

Proper breastfeeding, counselling & support

Assess adequacy of breastfeeding

If small babies not able to suck effectively on the breast

Expressed breast milk by alternate methods

Disclaimer: Doctoralerts is an educational platform. It does not provide medical advice, diagnosis, or treatment. We neither promote nor sell any type of prescription drug or supplement.

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