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 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, 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

    Your doctor will ask about your baby’s symptoms and medical history and perform a physical exam.
    The doctor will want to check the glucose levels. 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 medicines can lower the release of insulin or encourage the liver to release more glucose.
  • Prevention

    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. HealthyChildren.org website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Causes-of-High-Blood-Glucose-and-Low-Blood-Glucose.aspx . Updated January 17, 2012. Accessed December 10, 2012.

    Hypoglycemia. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/az/Site1128/mainpageS1128P1.html . Accessed December 10, 2012.

    Hypoglycemia. KidsHealth.org website. Available at: http://kidshealth.org/parent/diabetes%5Fcenter/diabetes%5Fbasics/hypoglycemia.html#a%5FTreating%5FLow%5FBlood%5FSugar%5FLevels . Updated October 2010. Accessed December 10, 2012.

    Hypoglycemia in the newborn. Lucile Packard Children’s Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/diabetes/hyponew.html . Accessed December 10, 2012.

    Neonatal hypoglycemia. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/ . Updated August 1, 2012. Accessed December 10, 2012.

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