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Hypoglycemia in Infants

(Neonatal Hypoglycemia; Pediatric Hypoglycemia)

Definition

Hypoglycemia in infants is when the level of glucose in the blood is too low. Glucose is a type of sugar that the body uses for energy. The body cannot work the right way when levels are low.

Causes

The body releases insulin to lower high levels of glucose. It releases stored glucose when glucose levels drop too low. Hypoglycemia happens when the body can no longer do this.

It is normal for some infants to have hypoglycemia during the first two hours after birth. Other problems that can lead to it are:

  • Low fat and glucose stores
  • Health issues that raise the need for glucose, such as fevers, seizures, or stress
  • High levels of insulin
  • Feedings that are delayed or do not happen often enough
  • Having other health problems, such as hemolytic disease

Risk Factors

This problem is more common in infants who are too small or large, born pre-term or post-term, or born to mothers with diabetes. Other things that raise the risk are:

  • Stress around childbirth, such as lack of oxygen or hypothermia
  • Birth defects and genetic problems
  • Lack of some hormones

Problems in the mother that raise an infant's risk of hypoglycemia are:

Symptoms

Most infants do not have symptoms. Those who do may have:

  • Irritability
  • Shaking
  • A weak or high-pitched cry
  • Seizures
  • Bluish skin
  • Poor feeding
  • Breathing problems

Diagnosis

You will be asked about your infant’s symptoms and health history. A physical exam will be done.

The infant's glucose levels will be checked. This can be done with blood tests.

Other tests may be done to find a cause.

Treatment

The goal of treatment is to raise glucose to normal levels. This can be done with:

  • Frequent feedings
  • Glucose that is given during feedings or by IV

Prevention

Mothers with diabetes may be able to prevent this problem in their newborn by breastfeeding or formula feeding early and often.

RESOURCES:

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

Kids Health—Nemours Foundation
http://kidshealth.org

CANADIAN RESOURCES:

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca

Health Canada
https://www.canada.ca

REFERENCES:

Causes of high blood glucose and low blood glucose. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Causes-of-High-Blood-Glucose-and-Low-Blood-Glucose.aspx. Updated May 1, 2018. Accessed December 31, 2019.

Hypoglycemia. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/diabetes_center/diabetes_basics/hypoglycemia.html#a_Treating_Low_Blood_Sugar_Levels. Updated October 2016. Accessed December 31, 2019.

Neonatal hypoglycemia. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/neonatal-hypoglycemia-22. Updated September 6, 2019. Accessed December 31, 2019.

Thornton PS, Stanley CA, et al; Pediatric Endocrine Society. Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children. J Pediatr. 2015 Aug;167(2):238-245.

Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 5/29/2020