What is Neonatal Hypoglycemia

Neonatal hypoglycemia is when a newborn’s blood sugar (glucose) level is too low in the first few days after birth. Babies need glucose for energy.

Before birth, babies get glucose from their mother through the placenta. The placenta is the organ inside the womb (uterus) that gives blood and nutrients to babies. After birth, babies get glucose from:

• Breast milk or formula.
• Their own liver.

What are the causes?

In some cases, neonatal hypoglycemia is a normal reaction after birth. However, this condition also may occur if:

• Your baby has too much of the hormone insulin in his or her blood. Insulin helps your baby’s cells absorb glucose for energy. If a mother has diabetes, the baby’s body makes insulin as a response to high glucose levels. After birth, the baby’s insulin level may remain high for a few hours to a few days, which can lower the baby’s blood sugar.
• Your baby is not making enough glucose. Your baby also may not have enough stored glucose in his or her body. This can happen if a baby is born early (prematurely) or is small at birth.
• Your baby’s body is using more glucose than he or she can make.
• Your baby is not taking in enough glucose through breast milk or formula.

Other causes of this condition include:

• Certain conditions your baby is born with (congenital) that affect how the body processes glucose.
• Certain medicines taken by the mother, such as some asthma treatments and heart medicines.

What increases the risk?

The following factors may make a baby more likely to develop neonatal hypoglycemia:

• Having a birth mother who has diabetes mellitus or gestational diabetes.
• Being born prematurely.
• Having a low birth weight.
• Having had poor growth before birth.
• Having an infection.
• Needing oxygen after birth.
• Having certain genetic conditions.
• Having low thyroid hormone levels.

What are the signs or symptoms?

Your baby can have this condition without showing any symptoms. If your baby has symptoms, they may include:

• Pale or bluish skin (cyanosis).
• Breathing problems, such as:
  • Slowed breathing.
  • Rapid breathing.
  • Making a grunting sound when breathing.
• Irritability.
• Loose or floppy movements.
• Poor feeding or sucking.
• Vomiting.
• Low body temperature.
• Shakiness.
• Sweating.
• Seizures.

How is this diagnosed?

This condition is diagnosed based on your baby’s symptoms and a blood test to check glucose and insulin levels. Even if your baby has no symptoms, these blood tests may be done if you or your baby have risk factors for this condition.

How is this treated?

Treatment for this condition may include:

• Feeding your baby with breast milk or formula within the first few hours after birth. Feedings may be done by mouth or through a tube that is put through your baby’s mouth or nose and into his or her stomach.
• Giving your baby a glucose solution through an IV inserted into one of your baby’s veins. This is done if your baby cannot feed by mouth or if his or her blood glucose levels are very low.
• Medicine to increase blood glucose levels.
• Making sure your baby maintains a normal body temperature by keeping him or her well wrapped or by placing him or her in an incubator (isolette).

Treatment is continued until your baby can maintain normal blood sugar levels.

Follow these instructions at home:

• Follow instructions from your baby’s health care provider for home feedings.
• Keep all follow-up visits as told by your baby’s health care provider. This is important.

Contact a health care provider if:

• Your baby’s symptoms return.
• Your baby has new symptoms.
• Your baby is not feeding well at home.

Get help right away if your baby has:

• Difficulty breathing.
• Pale or bluish skin.
• A seizure.

Summary

• Neonatal hypoglycemia is when a newborn’s blood sugar (glucose) level is too low in the first few days after birth.
• This condition is diagnosed based on your baby’s symptoms and a blood test to check glucose and insulin levels.
• Treatment for this condition may include feeding your baby with breast milk, formula, or a glucose solution. Medicine may be given to your baby through an IV if needed.
• Treatment is continued until your newborn can maintain normal blood sugar levels.