![]() ![]() Infants who have persistently low glucoses (<45 mg/dL) should be considered for IV dextrose treatment. If the subsequent test is still <45 mg/dL, further attempts to correct the glucose with up to 3 total doses of categorized as dextrose gel and continued supplemental feeding should be attempted. In an asymptomatic baby, a glucose level of less than 45 mg/dL should prompt dextrose gel with immediate feeding, and another glucose check in an hour. If the subsequent test is still 25 but <35 mg/dL, the infant should again be given dextrose gel, fed and retested, although IV fluid therapy may be indicated for some patients in this group.Īny glucose level less than 45 mg/dL in a baby with severe symptoms requires immediate IV fluid therapy. In an asymptomatic baby, an initial glucose level (within the first 4 hours of life) of less than 25 mg/dL should prompt treatment with dextrose gel and an immediate feeding, with another glucose check in an hour. Additional evaluation for other underlying disorders should also be considered for the symptomatic infant with hypoglycemia, unless symptoms resolve promptly with glucose correction.Īny glucose level less than 25 mg/dL in a baby with severe symptoms requires immediate IV fluid therapy. Glucose absorption from rubbing dextrose gel on a baby’s buccal mucosa has similar response time to administering IV dextrose. If an infant overall appears well, attempts can be made to correct hypoglycemia by feeding the infant and/or giving dextrose gel. ![]() The method for correcting hypoglycemia should be determined by the clinical status of the infant and considerations for how soon the intervention will normalize the glucose level. Symptoms such as suppressible tremors (jitteriness) and sleepiness occur in many infants who do not have hypoglycemia as part of normal newborn transition, so often these are “mild symptoms” of hypoglycemia and less invasive treatment is typically tried prior to IV dextrose. Prompt intervention is necessary in these cases, with consideration of immediate IV dextrose in the infant who is not well appearing. In recent years many hospitals have started using oral dextrose gel to treat asymptomatic hypoglycemia as well. Asymptomatic hypoglycemia is common among infants with risk factors and has historically been treated by ensuring the infant is getting adequate nutrition, which typically involves supplementation (banked breast milk or formula) as well as assisting mother to maximize colostrum expression in the hours after birth. ![]()
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