Hypoglycemia, or low blood sugar, during the first 2 – 72 hours after birth remains one of the most common metabolic conditions for newborns in Canada. Low blood sugar is a disorder that occurs when the body cannot produce enough insulin to regulate glucose in the bloodstream. Glucose levels measure how much sugar is in your blood.
It is common for all babies’ glucose levels to drop within the first two hours after labour and delivery. However, babies that experience or are at risk for hypoglycemia will have dramatic drops in glucose levels from the normal range. Glucose is essential for brain development and growth in a newborn baby. Treating hypoglycemia in newborns is quite simple and can be done effectively.
When a baby experiences low blood sugar, the body temperature can drop, bluish skin color, and shakiness. Preterm infants are at a higher risk of hypoglycemia because they cannot store as much energy as they need. Preterm infants will use up their glucose faster than they can generate it.
Signs and Symptoms of Neonatal Hypoglycemia
Neonatal hypoglycemia is when the blood sugar level falls below normal levels. Babies at risk for low blood sugar have low birth weight, low insulin production, and are preterm, underweight, or overweight for their age. The most common symptoms of hypoglycemia include:
- Cyanosis – a bluish discoloration of the skin and lips
- Apnea – the infant may stop breathing
- Hypothermia – low body temperature
- Shakiness
- Floppy muscles
- Lack of movement and energy
- Seizures
Severe hypoglycemia can cause an inability to breathe and movement, making it difficult for the child to function. If the medical conditions remain untreated, they can lead to seizures, breathing problems, heart rate changes, and brain damage. This is why it’s so necessary to get immediate medical care when an infant’s level of glucose drops.
Risk Factors for Hypoglycemia
Many different factors can cause hypoglycemia in infants. Some babies are more likely to have a low supply of glucose. In Canada, medical professionals should perform routine glucose checks on the following at-risk infants:
- Full-term babies that have congenital conditions, as in conditions present at birth, such as metabolic diseases, asphyxia (lack of oxygen) at birth, liver disease, and infection.
- Preterm babies, born more than three weeks before the due date, and underweight infants are at significant risk for low blood sugar and often struggle to regulate glucose levels.
- Babies born to a mother with diabetes, or gestational diabetes, are at a higher risk for neonatal hypoglycemia.
- Babies who are much larger for their gestational age.
How to Treat Hypoglycemia in Newborns and Infants
Checking for low blood sugar in an infant is standard practice and is checked by taking a few drops of blood from the baby’s foot for review for a blood test. If the blood sugar is low, the medical team will check to see how well the treatment works. Your doctor may do other tests to ensure that low blood sugar is not caused by another problem, such as an infection.
A baby with hypoglycemia needs more feedings to maintain glucose levels. Therefore, the baby may be given supplemental sugar in a glucose gel. The gel is rubbed inside the baby’s cheek or fed through a tube placed in the nose and funneled down to the stomach. The medical team will use a tube that goes through a vein if the baby has severe symptoms of low blood sugar.
Usually, low blood glucose levels in a baby will last for a few hours, but it can last 24-72 hours. Once the baby’s levels stabilize, most babies do not have any further problems with low blood glucose.
What is low blood sugar in babies?
All babies rely on glucose, or sugar, as an essential source of energy. A stable supply of glucose energy is important for normal activity, growth, and development. Low blood sugar is when the blood glucose level falls below normal levels. It’s common for all newborns to experience a drop in glucose levels just after birth, but it’s cause for concern if the levels stay low or drop below the normative range.
In the womb, babies receive glucose from their mother and store it in preparation for birth. Newborn babies are able to use the stores of glucose to keep normal blood sugar levels stable for the first few days of life. This sustains the baby until feeding routines can be established.
Do all newborn babies need blood glucose checks?
A newborn that is at risk for low blood sugar will be checked at 2 hours of life and then again periodically depending on the specific situation. Babies born at full term and who are not at risk do not need blood glucose checks, as they have enough stored energy to last until feeding is well established.
As some babies are more likely to have low blood glucose in the first few hours or days of life, they will get routine glucose checks starting at about 2 hours of age. These at-risk newborns are preterm babies, babies that are underweight or overweight for their gestational age, and babies whose mothers have diabetes.
What is the average level of blood glucose in a baby?
Blood glucose is measured in ‘millimoles’ per litre (mmol/L) which is a standard medical test report result. What is considered to be normal blood sugar levels changes with age but are usually lower in newborn babies than in older children.
Babies who need treatment for low blood glucose, are preterm, or are at risk for low blood glucose should aim to get to a level over 2.5 mmol/L, and this can take a bit longer to achieve.
What treatment will my baby have if it is diagnosed with low blood glucose?
The baby needs to be checked that there is no underlying illness and that the cause of the low glucose level is not serious. The standard treatment for low blood sugar is giving the baby extra feedings or an increased frequency of feedings if the blood glucose continues to stay low.
If the supplemental feedings do not raise the blood glucose level, the medical team may advise using an IV to deliver additional sugar. A normal blood glucose level should stabilize within 12 to 72 hours after delivery, and the baby is at the highest risk of dropping glucose levels during this time.
Neonatal Hypoglycemia Caused by Negligence
Suppose a baby had risk factors for hypoglycemia but testing was not done or testing was not done properly. In that case, there may be cause to investigate for negligence. An infant must have an early diagnosis and swift treatment for low blood sugar. If the condition is left untreated, the baby may suffer from brain damage or an injury.
A brain injury, or damage, caused by hypoglycemia, should be considered by a team of experienced injury legal counsel. There are guidelines established by the Canadian Pediatric Society that can determine if the healthcare professionals neglected to intervene in Canada.
John McKiggan, QC has represented clients in pediatric and adult injury claims that have resulted in multi-million dollar awards. In recognition of his accomplishments, John has been honoured by his peers, who elected him president of the Atlantic Provinces Trial Lawyers Association. He has also been named Queen’s Counsel, a designation recognizing exceptional professional merit. John has been selected for inclusion in the Best Lawyers in Canada in the field of personal injury law, he is listed in the Canadian Legal Lexpert Directory and has been named a local litigation star by Benchmark Litigation Canada.
