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How To Treat Low Blood Sugar In Newborn

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Where Do Babies Get Glucose

Neonatal Hypoglycemia Causes, Treatment & Prevention

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.

Diagnosis Of Neonatal Hypoglycemia

  • Bedside glucose check

All signs are nonspecific and also occur in neonates who have asphyxia, sepsis or hypocalcemia, or opioid withdrawal Opioids Alcohol and illicit drugs are toxic to the placenta and developing fetus and can cause congenital syndromes and withdrawal symptoms. Prescription drugs also may have adverse effects on the fetus… read more . Therefore, at-risk neonates with or without these signs require an immediate bedside blood glucose check from a capillary sample. Abnormally low levels are confirmed by a venous sample.

How To Treat Someone Who’s Having A Seizure Or Fit

Follow these steps if someone has a seizure or fit caused by a low blood sugar level:

  • Stay with them and stop them hurting themselves lie them down on something soft and move them away from anything dangerous .
  • After the seizure or fit stops, give them a sugary snack.
  • Tell your diabetes care team if you ever have a severe hypo that caused you to have a seizure or fit.

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    Symptoms And Signs Of Neonatal Hypoglycemia

    Many infants remain asymptomatic. Prolonged or severe hypoglycemia causes both adrenergic and neuroglycopenic signs. Adrenergic signs include diaphoresis, tachycardia, lethargy or weakness, and shakiness. Neuroglycopenic signs include seizure, coma, cyanotic episodes, apnea, bradycardia or respiratory distress, and hypothermia. Listlessness, poor feeding, hypotonia, and tachypnea may occur.

    Symptoms Of A Low Blood Sugar Level

    Neonatal Hypoglycemia: Symptoms, Causes, and Diagnosis

    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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    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.

    Blood Sugar Monitoring And Treatment In The Nicu

    Blood sugar is the amount of sugar in the blood. The body needs sugar to function. Blood sugar must stay in a certain range for the body to be healthy. A body chemical called insulin helps the body maintain a normal blood sugar level. In some newborns, blood sugar may be either too high or too low. So healthcare providers will carefully watch your babys blood sugar level in the neonatal intensive care unit . If your baby’s blood sugar is too high or too low, treatment will bring it back under control.

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    What Causes Low Blood Sugar In Newborns

    After birth, the energy i.e. the glucose or sugar needed for the brain and body are generally received through breastfeeding and self-production of the liver in babies. But chances are the blood sugar may drop for many varied reasons such as

    • The presence of high insulin in blood and insulin pulls sugar from the body leading to less glucose.
    • The infant isnt secreting the required amount of it.
    • The body and the brain of the baby is consuming more glucose in comparison to the production.
    • The baby isnt getting enough feed required to meet the glucose needed.

    Usually, this condition arises when the glucose level considered safe for the babies isnt present and 1 out of 3 for 1000 births have this problem.

    How Is Blood Glucose Checked

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

    Blood glucose is checked with just a few drops of blood, usually taken from your babys heel.

    If your baby is at-risk but doing well, blood glucose will be checked around 2 hours of age and then again before your baby feeds. In total, it will be checked about 3 to 5 times during the first and second days of life.

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    How To Treat Low Blood Sugar In Newborns

    Low blood sugar in newborns is referred to as neonatal hypoglycemia, and is generally experienced in the first few days after birth. The condition is experienced by 2 in every 1,000 newborns. In newborns, sugar is important for the energy supply of the brain during birth. Babies get their supply of sugar from the mother through the placenta before birth. After birth, the baby stores sugar in the heart, liver and muscles. Neonatal hypoglycemia can be caused by a number of reasons, and can be well managed to ensure the well-being of the baby.

    How To Avoid Low Blood Sugars

    Antenatal hand expression

    If you are reading this leaflet before your baby is born because it has already been identified that your baby may be at risk of low blood glucose, you may want to consider expressing some breast milk before your baby is born. This can be beneficial to supporting your babys blood glucose level regardless of whether you plan to breastfeed your baby or not. This is because it is thought that breast milk helps to activate the babys response mechanisms which supports them when their blood sugars drops.

    Research shows that if there are no other risk factors, expressing breast milk from 36 weeks in to your pregnancy should be safe for you and your baby.

    You will be shown how to hand express your milk and provided with syringes in which to collect it. The milk can then be labelled and stored in your own freezer ready to bring in when baby is born.

    If you are interested in doing this please see your Midwife for further support and information.

    Skin-to-skin contact

    Skin-to-skin contact with your baby on your chest helps keep your baby calm and warm and helps to encourage your babys natural instincts to feed. During initial skin-to-skin contact, your baby should wear a hat and be kept warm with a blanket or towel.

    Keep your baby warm

    Put a hat on your baby until they are able to maintain their own temperature effectively and then remove. Your Midwife will be able to guide you with this.

    Feed as soon as possible after birth

    Express your milk

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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 .

    How To Tell If Your Newborn Has Low Blood Sugar

    how to treat low blood sugar in newborn

    Low blood sugar in newborns does not usually come with visible signs and symptoms. However, by keenly watching your baby, you should be able to infer the lack of sufficient levels of blood sugar. It is also important to note that these signs will vary from child to child. If you note any of these symptoms in your child, then you need to go see a doctor immediately.

    • Blue coloring of the skin
    • Restlessness
    • Poor feeding of the newborn
    • Seizure attacks
    • Sluggishness

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    How Can Parents Help

    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.

    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.

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    What Is Low Blood Glucose

    You have been given this leaflet because your baby is at increased risk of having low blood glucose .

    Babies who are small, premature, unwell at birth, or whose mothers are diabetic , have gestational diabetes, or have taken certain medication, may have low blood glucose in the first few hours and days after birth, and it is especially important for these babies to keep warm and feed as often as possible in order to maintain normal blood glucose levels.

    If your baby is in one of these at risk groups, it is recommended that they have some blood tests to check their blood glucose level. Extremely low blood glucose, if not treated, can cause brain injury resulting in developmental problems. If low blood glucose is identified quickly, it can be treated to avoid harm to your baby.

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

    Hypoglycemia in Neonates

    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.

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    Treating Low Blood Sugar Prevents Brain Damage In Newborn Babies: Study

    Stabilising blood sugar levels in newborns with hypoglycemia, or low blood sugar, appears to prevent brain damage, according to the first study of its kind.

    The study, led by the Liggins Institute at the University of Auckland in New Zealand, is published today in The New England Journal of Medicine. It was funded by the National Institutes of Health in the United States and the Health Research Council of New Zealand.

    The lead researcher, Distinguished Professor Jane Harding, says the study shows that if doctors treat a baby with hypoglycemia to keep the blood sugar above a safety threshold, there is no increase in the risk of brain damage. This threshold, already widely used, is 2.6 millimoles per litre or 47 milligrams per decilitre.

    The study has also found that babies with blood sugar levels that were higher than usual appeared to be at risk of brain damage.

    Hypoglycemia is the single most preventable cause of brain damage in newborns. Up to 30 per cent of newborns are at risk, 15 per cent will be affected to at least some degree, and around 10 per cent end up admitted to intensive care, says Professor Harding.

    We know that a baby with a blood glucose level that is too low for too long will suffer neurological damage, but there has been debate about just how low, for how long, and in which babies. This is the first clear evidence that treating babies to keep their blood sugar above a widely-used safety intervention threshold does indeed protect them.

    Treatment For Hypoglycemia In The Newborn:

    The immediate treatment for hypoglycemia is giving the baby a rapid-acting source of glucose such as mixture of glucose/water or formula as an early feeding if baby is able to take by mouth. If baby is not responding and has seizures IV fluids containing glucose is the best choice to raise the blood glucose quickly. This will be followed by monitoring the blood glucose closely to see if hypoglycemia recurs again.

    Specific treatment for hypoglycemia will be determined by your baby’s physician based on:

    • Detailed medical history, complete physical exam and initial lab testing. Baby may need more extensive testing to figure out the exact cause of the hypoglycemia. Sometimes an elective fast may be discussed with you as an option in the hospital settings to reach the correct diagnosis.

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    Quick Note For Parents

    While it may be alarming to have low blood sugar in newborn, it is important to note that the condition does not usually result in serious problems in the later life of the child. This is especially the case if the child has only had a mild case of low blood sugar. With that said, it is important for both parents to play a role in their babys well-being by taking the child for check-ups and by feeding the child properly and frequently enough.

    Important aspects to observe in your child include the baby’s learning ability, hearing, vision and motor capabilities. The babys growth with regard to behavior and emotions should also be keenly observed. If possible, the baby should be checked regularly by a doctor.

    Transient And Persistent Neonatal Hypoglycemia

    Handling high and low blood sugar levels

    There are two different types of neonatal hypoglycemia, transient and persistent . Babies who have transient NH typically have a deficiency of glycogen stores at birth. This is common in babies that are born premature, who are small for gestational age, or experienced birth asphyxia. Transient NH babies also may experience hyperinsulinism, which occurs most often in babies born to diabetic mothers .

    Neonatal hypoglycemia can also occur if an IV infusion of glucose is interrupted for example, if the umbilical catheter is incorrectly positioned or the baby has sepsis. If the baby experiences NH due to an error of medication administration, this is medical malpractice.

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    Information For Family Friends And Co

    Use the following information to help someone who is too weak or confused to treat his or her low blood sugar.

    If the person is taking medicine that can continue to cause low blood sugar, stay with the person for a few hours after his or her blood sugar level has returned to the target range.

    • Make sure the person can swallow.
    • Lift the person’s head so that it will be easier for the person to swallow.
    • Give the person ½ teaspoon of water to swallow.
  • If the person can swallow the water without choking or coughing:
  • Give him or her about 15 grams of glucose or sucrose tablets or solution or fast-acting carbohydrate, such as 1 Tbsp of table sugar, ¾ cup fruit juice or regular soda pop, or 1 Tbsp honey.
  • Wait about 15 minutes.
  • If a blood sugar meter is available, check the person’s blood sugar level.
  • Offer the person another 15 grams of glucose or sucrose tablets or solution or fast-acting carbohydrate if he or she is feeling better but still has some symptoms of low blood sugar.
  • Wait about 15 minutes. If possible, check the blood sugar level again.
  • If the person becomes more sleepy or lethargic, call 911 or other emergency services.
  • Stay with the person until his or her blood sugar level is 4.0 mmol/L or higher or until emergency help comes.
  • If the person chokes or coughs on the water, or if the person is unconscious:
  • Do not try to give the person foods or liquids, because they could be inhaled. This is dangerous.
  • Stay with the person until emergency help comes.
  • Causes And Risk Factors

    Babies get glucose from their mothers through the placenta before they are born. After birth, their sources of glucose are breast milk and formula. Glucose is also produced in the liver. Blood sugar may drop when there is too much insulin , if the baby is not producing enough or using too much or if the baby is unable to feed.

    Some newborns have certain risk factors that make it easier for them to develop neonatal hypoglycemia. These may include:

    • Being born too early

    If your newborn is experiencing any of these symptoms, talk to the nurses and healthcare providers about blood tests. Even if the newborn does not have symptoms and you know there are risk factors, it’s still best to discuss these with your healthcare provider.

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