Glucose plays a vital role in human metabolism, and this is especially true for newborns. Among the most common metabolic disorders in this age group is neonatal hypoglycemia—a condition characterised by low blood glucose levels. Ideally, a newborn’s blood glucose should be maintained above 45 mg/dL. Hypoglycemia can occur even in the absence of symptoms, yet it poses a serious risk, potentially leading to permanent brain damage if not promptly recognised and treated.
While all newborns are susceptible to hypoglycemia, certain groups are at greater risk. These include preterm infants, babies with low birth weight, infants born to diabetic mothers, babies whose mothers are on glucose-lowering medications, infants with inborn errors of metabolism, and critically ill newborns—such as those with infections or in shock.
The symptoms of hypoglycemia in newborns can be highly variable. In many cases, the baby may show no clinical signs at all, despite having dangerously low glucose levels. For this reason, at-risk infants are routinely monitored through a blood sugar screening protocol, which involves checking blood glucose levels at regular intervals until the risk subsides.
When symptoms do occur, they may include listlessness, poor feeding, tremors, seizures, shock, inability to maintain body temperature, and bleeding. These signs warrant immediate evaluation and intervention.
The first step in managing hypoglycemia is assessing the baby’s blood glucose level. A glucometer offers a quick and cost-effective way to check blood sugar, but it may not be accurate when readings are extremely low. If a significantly low glucose level is detected, hospitalisation is recommended, especially if the baby is symptomatic.
However, if the glucose level is not below 25 mg/dL and the baby shows no symptoms, a trial of oral feeding may be considered. During this trial, the baby’s ability to maintain normal glucose levels on regular feeds is closely observed. Successful maintenance of glucose through feeding indicates that ensuring a regular and adequate feeding will be sufficient to maintain blood glucose level of the baby in the normal range.
In cases of severe hypoglycemia or when symptoms are present, the only effective treatment is through intravenous administration of fluids containing high glucose concentrations, along with steroids and other supportive medications.
Hypoglycemia in newborns is a medical emergency. Prompt recognition and timely medical intervention are crucial to prevent serious complications, including long-term neurological damage.
