HYPOGLYCEMIA

Definition: Low blood sugar.

1. What caused this condition to occur?

Hypoglycemia occurs when the baby’s blood sugar (glucose) is low, with a measure that is less than 40 mg/dL to 45 mg/dL. Low blood sugar is due to a disruption or abnormality in the baby’s blood sugar regulatory system and is most common in the first two hours after birth. Much of the time, it is corrected with early feeding and continued monitoring for the first twenty-four hours. Babies born to mothers with diabetes or babies that are large for their age may have a more significant decrease in the blood sugar levels and need monitoring of the blood sugar level for several days. In rare cases, severe and quite prolonged low–blood sugar levels may require surgery, special diet, and/or medication.

2. Is hypoglycemia dangerous, and will it have any permanent impact on my baby’s health?

In the majority of cases, when brief and treated promptly, there are no permanent effects of low blood sugar on the baby. However, untreated or prolonged blood sugar levels may lead to brain injury.

3. What tests are needed to further define the condition?

In most cases, a simple measurement of the blood sugar level by a machine at the bedside is all that is necessary. Sometimes a confirmation of the low measurement by the bedside machine will need to be performed. This is done by collecting a small amount of blood from the baby and sending it to the laboratory. In the rarer cases of severe and prolonged low blood sugar, blood levels of various hormones may be needed and may take several days to return.

4. How are we going to treat it, and are there any side effects that might occur from the treatments?

In most cases, the low blood sugar level is treated with either feedings alone or in combination with intravenous (IV) sugar solutions. Infrequently in more severe cases, medications may be also given either as an IV or by mouth. There are generally no side effects.

5. How long will the condition take to correct?

In infants that are born to mothers without diabetes and are normal size for their age, normal blood sugar levels will generally be obtained within three to six hours of birth and monitoring may continue for up to twenty-four hours. In infants that are born to mothers with diabetes or are large for their age, the ability to maintain normal blood sugar levels without treatment and monitoring may take three to five days or longer.

6. Is there a chance the condition might come back following discharge from the hospital, and is there any special need for follow-up?

As long as the baby is feeding normally, the vast majority of babies will not have any recurrence of low blood sugar, and no special follow- up is needed. In the rare cases of severe and prolonged low blood sugars where surgery, medications, and/or a special diet has been required, those infants will need continued monitoring at home and follow-up with pediatric endocrinologists, doctors that specialize in disorders of hormone levels or metabolism.

7. Does hypoglycemia predispose my baby to developing diabetes or any other sugar metabolism disorder later in life?

Infants born to long-standing diabetic mothers may have a genetic predisposition to developing diabetes. Infants born to mothers with high blood sugars during the pregnancy or mothers with later onset diabetes are not at an increased risk for developing diabetes later in life, but may be at higher risk to be obese in the preteen and teenage years.

8. Will future babies that I might have be more inclined to have hypoglycemia? Is there any precaution that I can take to prevent it from happening again?

Mothers that have high blood sugars or diabetes, either when not pregnant or just when pregnant, will continue to have infants that are at higher risk for low blood sugars after birth. Monitoring of blood sugars during pregnancy as needed and maintaining good control of the blood sugar levels prior to and during the pregnancy will decrease the risk of the infant.

9. After discharge from the hospital, when do you wish to see my baby again for this condition?

In the large majority of babies, there is no need for special follow-up. Babies should have demonstrated that they can maintain normal blood sugar levels for a period of time prior to discharge and are expected to continue to do so. 

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