Hypoglycaemia of the New Born
·
Not a big deal, but needs to be
recognised and managed
· Causes (either big babies or small babies):
o Hyperinsulin: Child of poorly controlled diabetic mother. Maternal glucose ® fetal glucose ® fetal insulin (important growth factor in utero) ® fatter and larger baby, haemoglobin
o Small babies: Double whammy: lack of substrate and requirements
(eg cold quicker)
o If septic or otherwise sick (may also go hyperglycaemic due to cortisol
and adrenaline)
· Symptoms:
o Usually none. Can be asymptomatic at < 1 mmol/litre of glucose [would cause convulsion in adult]
o May be jittery (but most common cause is difficult delivery)
o Convulsions or floppy (post-ictal) – late sign
·
Prevention:
o Identify at risk babies and monitor blood glucose
o Feeding is usually required (normal babies can go 48 hours without a
feed)
o May need IV glucose
o Prevent hypothermia. If they‟re
small and get cold they will become hypoglycaemic
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