The screening and management of newborns at risk for low blood glucose

Abstract

Hypoglycemia in the first hours to days after birth remains one of the most common conditions facing practitioners across Canada who care for newborns. Many cases represent normal physiologic transition to extrauterine life, but another group experiences hypoglycemia of longer duration. This statement addresses key issues for providers of neonatal care, including the definition of hypoglycemia, risk factors, screening protocols, blood glucose levels requiring intervention, and managing care for this condition. Screening, monitoring, and intervention protocols have been revised to better identify, manage, and treat infants who are at risk for persistent, recurrent, or severe hypoglycemia. The role of dextrose gels in raising glucose levels or preventing more persistent hypoglycemia, and precautions to reduce risk for recurrence after leaving hospital, are also addressed. This statement differentiates between approaches to care for hypoglycemia during the 'transitional' phase-the first 72 hours post-birth-and persistent hypoglycemia, which occurs or presents for the first time past that point.

Keywords: Dextrose gel; Hypoglycemia; Newborn; Point-of-care.