Hypoglycemia in a Newborn Baby

Hypoglycemia is when the level of sugar (glucose) in the blood is too low. Glucose is the main source of fuel for the brain and the body. In a newborn baby, low blood sugar can happen for many reasons. It can cause problems such as shakiness, a blue color to the skin, and breathing and feeding problems.

Hypoglycemia can be caused by conditions such as:

• Fetal growth restriction (slow growth prior to birth) or small size for gestational age at birth
• Prematurity
• Baby making more insulin than they need because birth parent has diabetes, especially if diabetes is not well controlled
• More insulin in the baby's blood for other reasons, such as large size for gestational age, genetic syndromes, or a tumor of the pancreas
• Congenital metabolic diseases or hormone deficiencies. Some of these run in families.
• Not enough oxygen at birth (birth asphyxia)
• Liver disease
• Sepsis/infection
• Incompatible blood types of birth parent and baby (severe hemolytic disease of the newborn)

Babies who are more likely to have hypoglycemia include those who are:

• Born to birth parents with diabetes
• Small for gestational age or growth-restricted
• Preterm babies, especially those with low birth weights
• Born under significant stress
• Born to birth parents treated with certain medicines such as terbutaline or steroids
• Large for their gestational age

Signs of low blood sugar may not be easy to see in newborn babies. The most common signs include:

• Shakiness
• Blue color of skin and lips (cyanosis) or skin looks pale
• Stopping breathing (apnea) or fast breathing a grunting
• Low body temperature (hypothermia)
• Floppy muscles (poor muscle tone)
• Not seeming interested in feeding or unable to feed
• Lack of movement and energy (lethargy)
• Seizures
• Weak or high-pitched cry

The signs of hypoglycemia can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

A simple blood test for blood glucose levels can diagnose the problem. The baby's blood level will be compared to an expected range for their age.

Treatment will depend on your baby's gestational age and overall health. Treatment includes giving the baby a fast-acting source of glucose. This may be as simple as a glucose and water mixture, breastmilk, or formula as an early feeding. Or your baby may need glucose given through an IV (intravenous) line. The baby's blood glucose levels are checked after treatment to see if the hypoglycemia occurs again.

The brain needs blood glucose to function. Not enough glucose can harm the brain's ability to function. Severe or long-lasting hypoglycemia may cause seizures and serious brain injury.

In many cases, there may not be a way to prevent hypoglycemia in a newborn baby. For a baby with risk factors, healthcare providers will need to watch carefully for the signs and start treatment as soon as possible. Birth parents with diabetes should keep their blood glucose levels in a normal range during pregnancy. This may help lower the risk for their baby. If you have trouble managing your diabetes, ask your healthcare provider for help and support.

Call your baby’s healthcare provider right away or get immediate medical care if you see signs of low blood sugar in your baby. Feed your baby and give supplemental formula or a glucose and water mixture if advised.

• Hypoglycemia is a condition that occurs when the level of glucose in the blood is lower than normal.
• A baby is at risk if they have a birth parent with diabetes, are preterm, or are smaller or larger than expected for their gestational age.
• If your baby has signs of hypoglycemia, feed them. Give supplemental formula or a glucose and water mixture if advised.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.