Neonatal Hypoglycemia – Causes, Symptoms & Prevention

Due to a multitude of reasons, a baby can be diagnosed with hypoglycemia. However, it’s common among many newborns. Their blood sugar levels drop immediately after delivery and climb to the safe range once they are being normally fed.

The usual process of neonatal examination in a hospital shortly after birth, designed to ensure the well-being and overall health of a baby reveals hypoglycemia. They don’t permit leave until the infant’s blood sugar is under the normal range.

In rare cases, because of some internal conditions, a baby’s blood sugar levels continue to be low. This causes symptoms such as breathing and feeding difficulties, lethargy, shakiness, and a blue color to the skin, among others.

Hypoglycemia in newborns can be treated. If left unchecked, it can cause permanent damage. So, it’s necessary to take quick action if you detect any signs of the condition in your little one.

Causes of Neonatal Hypoglycemia

Here are the most common causes of infant hypoglycemia.

1. Temporary Hypoglycemia

When a baby is inside the uterus, the placenta membrane delivers all the nutrients through the umbilical cord attached to the navel. That’s how a fetus keeps growing without eating or drinking anything. Post delivery, the doctors clamp the umbilical cord and cut it. This disturbs the infant’s source of nutrition, which also includes glucose.

This is called transitional hypoglycemia and is a normal part of delivery. Mostly, this drop doesn’t cause any lasting damage and is of a mild nature. Their blood sugar levels will normalize soon after they start feeding; their body is given nutrition.

2. Unmet Feeding Needs

After birth, some infants are not fed adequately. Some mothers struggle to meet the feeding needs of their babies through their breast milk. Further, carelessness in feeding early or on-demand can also lower blood glucose levels.

3. Infants of Diabetic Mothers (IDM)

Babies whose mothers have diabetes are supplied with more sugar than is needed. This is because the mother’s bloodstream has a high sugar level. As a result, the fetus produces more insulin. Insulin is a hormone that delivers glucose to all the cells in the body. Insulin is like a key that unlocks the cells in the body and the brain for glucose to enter.

Relation Between Diabetes in a Mother And Hypoglycemia in an Infant

A diabetes patient’s pancreas doesn’t make enough insulin, which is like delivery trucks for the packages (glucose). The lying packages or high amounts of sugar in their blood cause many problems like heart disease, nerve damage, and so on. Therefore, they take medicines to up the levels of insulin.

There are beta cells inside the pancreas always checking the sugar levels in the bloodstream like a watchman. After we eat, the intestines absorb the nutrition from the food, and so glucose gets released in the blood. This is when our sugar levels increase. The pancreas promptly increases insulin production to supply sugar to the cells and balances the amount of sugar in the bloodstream, not letting it increase nor allowing it to drop.

If diabetes is not managed well, the umbilical cord supplies the fetus with a high amount of sugar. Consequently, their pancreas will react by releasing more than normal levels of insulin to balance the sugar level. The fetus gets habituated to this more-than-normal sugar supply and reacting to it by making more insulin.

Post delivery, a baby is being fed normally, and normal levels of glucose get released in the bloodstream. However, still, their pancreas is producing more insulin. In this case, the packages are of a normal amount, but the delivery trucks are in excess. As a result, more packages (glucose) get delivered to a single location (cell), transferring too much energy, and very less packages or glucose are left in the bloodstream.

If someone gave you too much food to eat in just under a minute, how would your body react? It won’t react well, right? That’s what happens in this case as well. Symptoms such as seizures, shakiness, cyanosis, and so on start to appear.

Risk Factors of Hypoglycemia in an Infant

An infant is more prone to develop hypoglycemia if they belong to the following groups.

1. Larger Than Usual Size at Birth

Compared to a normal-sized baby, a large baby has more glucose and metabolic demands. This raises the chances of developing hypoglycemia as breastmilk and formula may fail to meet their needs.

2. Smaller Than Usual Size at Birth

A baby who is small for their gestational age won’t have as many fat stores and glycogen storage necessary to keep the body functioning normally. Consequently, their body’s ability to produce glucose is far less, and the shortage drops their blood sugar level.

3. Preterm Birth

A birth that takes place before the 37th week of pregnancy indicates that the baby’s body is not yet very capable of producing glucose on its own. Therefore, they don’t make the best use of breastmilk or formula for their nutritional needs. Also, a mother’s breast milk supply might not be as good during this time as it could have been if the baby took birth a few weeks later. So, it may contribute to low glucose supply as well.

Signs and Symptoms of Hypoglycemia in Infants

The most common signs and symptoms of hypoglycemia in infants include

• Showing less interest in feeding
• Floppy or weak muscles
• Drop in body temperature
• Low energy levels
• Shakiness
• Seizures
• White or blue discoloration of the skin and lips

Prevention And Management of Neonatal Hypoglycemia

Transitional hypoglycemia is not rare, and it’s safe to call it harmless. But to ensure that it doesn’t last long, certain measures should be taken

• Early identification of hypoglycemia symptoms in a newborn
• Feeding them within the first hour of delivery
• Testing their blood sugar level 30 minutes after their first feed
• Adopting supplementation for infants who have difficulty feeding

Treatment options may include providing the baby with infusions such as dextrose, glucagon, glucocorticoids, etc. The attending doctors will decide on the treatment options depending on the baby’s health condition.

Breastfeeding And Hypoglycemia

Doctors usually advise increasing the frequency of feeding sessions to deal with hypoglycemia. However, sometimes a mother may not be able to supply as much breast milk as is required to increase the blood glucose levels. So, if possible, donor milk (milk from someone other than the birthing parent) should be given. One can supplement with formula as well.

Seeking Medical Attention

A baby’s gestational age and overall health decides which treatment will be suitable for them. Healthcare professionals may give them a source of glucose which is fast-acting. Or, water and glucose mixture. Further, it can be as simple as formula and breastfeeding. For some babies, it may be crucial to provide them with glucose through an IV (intravenous) line.

For the majority of cases, hypoglycemia in newborns is temporary. However, if the problem persists, the parents or caregivers should seek immediate medical attention. One can detect infant hypoglycemia by identifying symptoms such as shakiness, lethargy, seizures, or a lack of interest in feeding. Hypoglycemia is treatable and there’s no need to worry as medical science has come up with highly effective methods to address this condition.

FAQ’s

1. What is Infant Hypoglycemia And Why is it a Concern For Newborns?

Infant hypoglycemia means a baby has less than normal amounts of glucose in their blood. As glucose is the main source of energy for the brain and the body, it can hamper their functioning. It results in symptoms like seizures, shakiness, and low body temperature, among others.

2. What Are The Common Causes of Low Blood Glucose in Newborns?

After birth, doctors cut the umbilical cord attached to the baby’s navel. Up until now, the baby relied on it as its only source of nutrition, including glucose. Here onwards, they will need to get their nutrient supply from breastmilk or feeding. So, there’s a transition in the source of nutrition. After their first few feeding sessions, their glucose levels start to normalize. Other common causes are preterm birth, large or small size at birth, or maternal diabetes.

3. How Can I Prevent Low Blood Glucose in my Newborn?

Early detection of infant hypoglycemia and then supplying them with more glucose through increasing the number of feeding sessions, oral sugar gels, etc. prevent low blood glucose in infants.