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Neonatal Hypoglycemia

  • David H. Adamkin
Chapter

Abstract

The management of low blood glucose concentrations in the first 48 h of life is one of the most frequently encountered issues the clinician faces in the newborn nursery. The blood levels of glucose upon which we base our decision-making remain more a matter of expert opinion rather than being evidence-based, and a consensus on blood glucose levels that should be treated in the newborn has not been definitive enough to gain consensus.

This lack of consensus has led to further confusion for the clinician as two pediatric organizations, the Committee on the Fetus and Newborn from the American Academy of Pediatrics (AAP) and the Pediatric Endocrine Society (PES), have recently provided expert opinion on the management of neonatal hypoglycemia that suggested different ranges of actionable blood glucose levels. The AAP guidance applies only to the first 24 h of life, while the PES strategy focuses on infants beyond 48 h of life with the emphasis on assuring that cases of persistent hypoglycemia are identified before these infants are discharged.

This chapter will provide an approach to neonatal hypoglycemia that incorporates both opinions and will provide management that meets the newborns’ energy requirements while still promoting successful breastfeeding and preventing unnecessary NICU admissions.

Keywords

Hypoglycemia Glucose LGA (large for gestational age) SGA (small for gestational age) Infant of a diabetic mother Late preterm 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Neonatal Medicine, Department of PediatricsUniversity of LouisvilleLouisvilleUSA

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