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Neonatal Hypoglycaemia

BNFC Treatment summaries Hypoglycaemia - Neonatal hypoglycaemia in term babies. BAPM Identification and Management of Neonatal Hypoglycaemia in the Full-Term Infant (Birth – 72 hours) A BAPM Framework for Practice. Jan 2024

Background Information

Risk factors for hypoglycaemia in full-term infants include:

Maternal diabetes
Maternal use of beta blockers
Infants with fetal growth restriction

Guidelines

BAPM recommends that ward-based blood gas analysers can provide accurate and rapid measurement of neonatal blood glucose concentration.

Management largely depends on whether the infant is symptomatic or not and on the blood glucose level.

IV glucose is indicated if:

Baby is symptomatic, or
Blood glucose <1.0 mmol/L

Feeding interventions can be trialled first:

Increase breastfeeding frequency
Supplementing with formula feed is usually sufficient
Consider buccal glucose gel

Re-check blood glucose in 1 hour to ensure there has been a response.

If feeding interventions are not effective → IV glucose 10% infusion.

Treat immediately with IV glucose 10% infusion (2.5 mL/kg)

If there is a delay in obtaining IV access → consider buccal glucose gel / IM glucagon

References

BNFC Treatment summaries Hypoglycaemia - Neonatal hypoglycaemia in term babies
BAPM Identification and Management of Neonatal Hypoglycaemia in the Full Term Infant (Birth - 72 hours)

Background Information

Guidelines

References

Author: Adams Lau
Reviewer:
Last edited: 05/06/25

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