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Neonatal hypoglycemia

Contents of this page:

Definition    Return to top

Neonatal hypoglycemia is low blood sugar (glucose) in the first few days after birth.

Causes    Return to top

Babies need sugar (glucose) for energy. Most of that glucose is used by the brain.

The developing baby gets glucose from the mother through the placenta. After birth, the baby gets glucose by producing it in the liver and from food.

Glucose levels can drop if:

Neonatal hypoglycemia occurs when the newborn’s glucose level is:

Hypoglycemia is the most common metabolic problem in newborns. It occurs in approximately 1 - 3 out of every 1,000 births.

Infants with the following risk factors are at high risk for neonatal hypoglycemia:

Symptoms    Return to top

Infants with hypoglycemia may not have symptoms. If they do occur, symptoms may include:

Exams and Tests    Return to top

Newborns at risk for hypoglycemia should have a blood test to measure blood sugar levels every few hours after birth. The health care provider should continue taking blood tests until the baby’s blood sugar level is normal.

Other possible tests:

Treatment    Return to top

Infants with hypoglycemia may need to receive:

Treatment normally continues for a few days to 1 week.

If the low blood sugar continues, the baby may also receive medication to increase blood glucose levels (diazoxide) or to reduce insulin production (ocreotide).

In rare cases, newborns with very severe hypoglycemia who don’t improve with treatment may need surgery to remove part of the pancreas (to reduce insulin production).

Outlook (Prognosis)    Return to top

The outlook is good for newborns who don’t have symptoms, or whose hypoglycemia gets better with treatment. However, hypoglycemia can return in a small percentage of babies after treatment.

The condition is more likely to return when babies are taken off intravenous feedings before they are fully ready to eat by mouth.

Babies with symptoms, especially those born at a low weight or to mothers with diabetes, are more likely to develop problems with learning.

Possible Complications    Return to top

Severe or long-term hypoglycemia may lead to brain damage, affecting normal mental function. Complications may include:

When to Contact a Medical Professional    Return to top

Call your health care provider if your baby has symptoms of neonatal hypoglycemia.

Prevention    Return to top

If you have diabetes during pregnancy, work with your health care provider to control your blood sugar levels.

References    Return to top

Stanley CA, Baker L. The causes of neonatal hypoglycemia. N Engl J Med. 1999 Apr 15;340(15):1200-1.

Newborn Nursery QI Committee. Guideline: Neonatal hypoglycemia: initial and follow up management. Portland (ME): The Barbara Bush Children's Hospital at Maine Medical Center; 2004 Jul. 4 p.

Cryer P. Glucose Homeostasis and Hypoglycemia. In: Kronenberg, HM, Melmed S, Polonsky KS, Larsen PR, eds. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders; 2008:chap 33.

Still BJ, Kliegman RM. The Endocrine System. In: Behrman RE, Kliegman RM, Jenson HB. Behrman: Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: Saunders; 2004:chap 96.

Update Date: 3/24/2008

Updated by: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review provided by VeriMed Healthcare Network.

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