neonatal_hypoglycaemia_flashcards

Question 1

What are the prevention measures for neonatal hypoglycaemia?

Answer 1

Feed baby within 30 mins of birth, subsequent frequent milk feeding (every 2-3 hours).

Question 2

What is the management for asymptomatic neonatal hypoglycaemia?

Answer 2

Confirm hypoglycaemia with laboratory blood glucose assay, support breastfeeding technique, offer additional feed and increase frequency, supplement with a breast milk substitute or IV glucose, use buccal glucose gel with a feeding plan, remeasure blood glucose levels in 1 hour, inform neonatal doctor, use glucose 10% IV infusion if first-line interventions are not effective.

Question 3

What should be done if pre-feed glucose is <2mmol/L or the baby is symptomatic?

Answer 3

Immediate glucose IV infusion, initial bolus of 2ml/kg 10% glucose, followed by an infusion of 3.6mL/kg/hour of 10% glucose, aim for 3-4mmol/L levels.

Question 4

What should be considered if there is a delay in obtaining IV access?

Answer 4

Consider buccal glucose gel or IM glucagon.

Question 5

What should be done if glucose is <1mmol/L?

Answer 5

Use buccal glucose gel as an interim measure while arranging IV glucose infusion.

Question 6

What should be done if hypoglycaemia is persistent?

Answer 6

Refer to endocrinology team for further investigation.

Question 7

What treatments can be given if hypoglycaemia is secondary to hyperinsulinism?

Answer 7

Glucagon infusion, diazoxide + chlorthiazide, somatostatin analogue.