Recognizing infants at risk of neonatal hypoglycemia and instituting early measures to prevent and treat low glucose concentrations are the subject of a clinical report published in the March issue of Pediatrics.
Recognizing infants at risk of neonatal hypoglycemia and instituting early measures to prevent and treat low glucose concentrations are the subject of a clinical report published in the March issue of Pediatrics.
The Committee on Fetus and Newborn offers up the guidance because of an absence of evidence to define clinically important neonatal hypoglycemia, and managing it remains largely empirical.
Infants most at risk of neonatal hypoglycemia are those who are small for gestational age, whose mothers have diabetes, and those who are late preterm. Another group at risk are infants who are large for gestational age. Blood glucose screening should focus on these infants, according to the committee.
Late-preterm infants and infants who are small for gestational age should be screened before each feeding (every 2 to 3 hours) for at least the first 24 hours. Screening should continue beyond 24 hours if plasma glucose concentration remains lower than 45 mg/dL.
Infants with clinical signs of hypoglycemia-jitteriness, cyanosis, seizures, apnea, tachypnea, weak or high-pitched cry, lethargy, floppiness, poor feeding, or eye rolling-should have their plasma or blood glucose concentration measured as soon as possible.
Rapid measurement of blood glucose concentration can be achieved with a bedside reagent test-strip glucose analyzer, although their accuracy may be off as much as 20 mg/dL. For this reason, the level obtained with any rapid bedside analyzer must be confirmed by laboratory testing ordered stat.
“The definition of a plasma glucose concentration at which intervention is indicated needs to be tailored to the clinical situation and the particular characteristics of a given infant,” the researchers write. A reasonable cutoff for treating symptomatic infants with IV glucose is 40 mg/dL, with a reasonable goal being maintenance of plasma glucose level in the range of 40 mg/dL to 50 mg/dL.
In at-risk asymptomatic infants from birth to 4 hours of age, if the glucose concentration at the initial screen is
In asymptomatic infants who are 4 to 24 hours old, if the glucose concentration at the initial screen is
Committee on Fetus and Newborn. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127(3):575-579.
Stress ulcer prophylaxis does not provide prevention of gastrointestinal bleeding in neonates
December 4th 2023In a poster abstract presented at the American Society of Health-System Pharmacists Midyear Clinical Meeting & Exhibition held in Anaheim, California, stress ulcer prophylaxis (SUP) did not appear to provide benefit for prevention of gastrointestinal bleeding and did not increase SUP-associated adverse effects.
Hematocrit levels in newborns: EPP vs DCC study reveals surprising findings
November 15th 2023A recent study in JAMA Network Open investigates the impact of extrauterine placental perfusion versus delayed cord clamping on hematocrit levels in newborns, shedding light on potential alternatives for optimizing infant outcomes during birth.
Preterm infant HRQOL: Long-term impacts and determinants
October 21st 2023A recent study was highlighted at the 2023 American Academy of Pediatrics National Conference & Exhibition that shed light on the long-term impact of very preterm birth on the health-related quality of life (HRQOL) of infants and identified key determinants.
Associations between prenatal metal mixture exposure and negative infant outcomes
September 19th 2023Francheska M. Merced-Nieves, PhD, Assistant professor, Departments of Pediatrics and the Institute for Exposomic Research of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, explains the associations prenatal exposure to a metal mixture and the potential negative effects for the infant.