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by Kassir K

Hypoglycemia in Infants

(Neonatal Hypoglycemia; Pediatric Hypoglycemia)

Definition

Glucose is a type of sugar. It is the body’s main source of energy.
Hypoglycemia is when the level of glucose in the blood becomes too low. When blood glucose drops too low, the body does not have enough energy to function properly. Hypoglycemia in infants occurs in babies less than one year old.

Causes

The body can normally balance the amount of glucose in the blood. The body will release insulin to reduce high levels of glucose in the blood. When blood glucose levels drop too low, the body can release stored glucose. Hypoglycemia occurs when these factors are disrupted.
Situations that can lead to hypoglycemia include:
  • Low fat and glucose stores—common in small for age or premature babies
  • Conditions that increase the use of glucose such as fevers, seizure, or stress
  • High levels of insulin
Newborns can also have hypoglycemia during the first 2 hours after birth. This is often a temporary situation. Your child’s body will adjust soon after birth.

Risk Factors

Factors that increase an infant’s risk of hypoglycemia due to low glucose stores include:
  • Premature birth
  • Low birth weight
  • Situations that use high amounts of glucose such as perinatal stress, cold stress, infection, fever, respiratory distress, and seizures
  • Birth defects
Factors that increase an infant’s risk of hypoglycemia due to high insulin include:
  • Diabetes in the mother during pregnancy
  • Higher than normal birth weight
  • Medications used to treat high levels of glucose
  • Syndromes that cause excess insulin such as Beckwith-Wiedemann syndrome, Sotos syndrome, Kabuki syndrome
Gestational Diabetes
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Other factors include:
  • Genetic mutations
  • Hormone deficiencies
Factors in the mother that increase a child’s risk of having hypoglycemia include:
  • Diabetes
  • High blood pressure
  • Having delivered a prior child with increased birth weight
  • Medications such as beta blockers
  • Illegal drug use

Symptoms

Symptoms of hypoglycemia may include:
  • Irritability
  • Trembling
  • A high-pitched cry
  • Seizures
  • Bluish skin
  • Refusal to feed
  • Easily startled
  • Breathing problems

Diagnosis

You will be asked about your baby’s symptoms and medical history. A physical exam will be done.
Your baby's glucose levels will be checked. This can be done with blood testing.
The doctor will also want to determine the cause of your baby’s hypoglycemia. Tests will be done based on the suspected cause. They may include blood tests, scans to create images of organs, or genetic testing.

Treatment

Talk with your doctor about the best treatment plan for your baby. Treatment will focus on increasing the glucose in your baby’s blood. Underlying issues may also need to be treated. Options include:

Frequent Feedings and Glucose

Frequent feedings may help raise blood glucose levels in infants. Infants may also be given a glucose mixture with feedings or by IV. This may be done until the infant’s blood glucose level is stable.

Medications

Medication is usually not needed for hypoglycemia alone. It may be given to treat underlying conditions. Some medications can lower the release of insulin or encourage the liver to release more glucose.

Prevention

To prevent hypoglycemia in infants:
  • Breastfeed or formula feed early and often.
  • If you have diabetes during pregnancy, keep it in good control.

RESOURCES

American Academy of Pediatrics
http://www.healthychildren.org
KidsHealth.org
http://kidshealth.org

CANADIAN RESOURCES

Canadian Paediatric Society
http://www.cps.ca
Health Canada
http://www.hc-sc.gc.ca

References

Causes of high blood glucose and low blood glucose. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Causes-of-High-Blood-Glucose-and-Low-Blood-Glucose.aspx. Updated May 17, 2013. Accessed September 30, 2014.
Hypoglycemia and low blood sugar. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/az/Site1128/mainpageS1128P1.html. Accessed September 30, 2014.
Hypoglycemia. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/diabetes%5Fcenter/diabetes%5Fbasics/hypoglycemia.html#a%5FTreating%5FLow%5FBlood%5FSugar%5FLevels. Updated September 2013. Accessed September 30, 2014.
Hypoglycemia in the newborn. Lucile Packard Children’s Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/diabetes/hyponew.html. Accessed September 30, 2014.
Neonatal hypoglycemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 7, 2014. Accessed September 30, 2014.

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