Neonatal hypoglycaemia

Question 1

What level of glucose should you aim for in neonates

Answer 1

> 2.6

Question 2

When should newborns have their first feed

Answer 2

Within 3 hours

Question 3

Risk factors for neonatal hypoglycaemia

Answer 3

Intrauterine growth restriction
Maternal diabetes
Small/large for gestational age
Preterm (<37 weeks)
Maternal beta blockers or TCA
Hypothermia
Sepsis

Question 4

Why are preterm/SGA babies at higher risk of hypoglycaemia

Answer 4

Less build up of glycogen and brown fat

Question 5

Why does IUGR and maternal diabetes lead to a higher risk of hypoglycaemia

Answer 5

Fetal hyperinsulin secretion

Question 6

Symptoms of hypoglycaemia

Answer 6

Jitteriness
Poor suck
Peripheral cyanosis
Tachypnoea
Poor feeding 
High pitched cry
Hypothermia
Seizures
Cardiac arrest/unresponsive

Question 7

Management of glucose <1

Answer 7

IV bolus through umbilical vein catheter of 2ml/kg 10% dextrose
If glucose hasn’t increased by at least 2ml/kg/min switch to an IV 10% dextrose infusion
Oral feeding as tolerated

Question 8

Management of glucose 1-2.5

Answer 8

increase glucose by at least 2ml/kg/min with IV 10% dextrose infusion
Oral feeding as tolerated

Question 9

Management of glucose >2.5

Answer 9

Oral feeding

Wean IV 10% dextrose