Hypoglycaemia

Question 1

Define neonatal hypoglycaemia

Answer 1

<2.6mmol/L glucose

Question 2

Is hypoglycaemia normal in neonates?

Answer 2

Normal term babies often have hypoglycaemia especially in the first 24hrs of life but without any sequelae, as they can utilise alternate fuels like ketones and lactate

Transient hypoglycaemia in first hours after birth is common

Question 3

Persistent/severe neonatal hypoglycaemia causes

Answer 3

Preterm birth (< 37 weeks)

Maternal diabetes mellitus

IUGR

Hypothermia

Neonatal sepsis

Inborn errors of metabolism

Nesidioblastosis

Beckwith-Wiedemann syndrome

Question 4

Clinical features of autonomic neonatal jaundice

Answer 4

Jitteriness

Irritable

Tachypnoea

Pallor

Question 5

Clinical features of neuroglycopenic neonatal jaundice

Answer 5

Poor feeding/sucking

Weak cry

Drowsy

Hypotonia

Seizures

Question 6

Management of asymptomatic neonatal jaundice

Answer 6

Encourage normal feeding (breast or bottle)

Monitor blood glucose

Question 7

Management of symptomatic neonatal jaundice

Answer 7

Admit to the neonatal unit

IV infusion of 10% dextrose