When it comes to newborns, low blood sugar, also called hypoglycemia, is one of the most common medical issues. Read on to learn why low blood sugar levels are so common in newborns, why it sometimes becomes a problem, and what parents and healthcare providers can do to help.
Almost all newborn babies have a drop in blood sugar during the first few hours of life. This is part of the normal transition after birth.
Babies are most likely to have blood sugar problems if they have risk factors causing high insulin levels or low glycogen stores.
Blood sugar problems in newborns are temporary and usually resolve within hours or days.
Healthcare providers are looking for low blood sugars in newborns and will provide treatment if necessary.
Although serious consequences of low blood sugar in newborns are possible, they are rare, and most babies do not have any long-term effects.
Normal blood sugar regulation in newborns
Before birth, babies get a steady stream of sugar, also called glucose, through the umbilical cord. In response, the fetus produces insulin, a hormone that converts that sugar into a form that can be used by the body or stored for future use. Some of that sugar will be stored in a form called glycogen.
The clamping of the umbilical cord after birth causes a sudden stop to the baby’s sugar supply. As a result, all newborns will have a brief drop in blood sugar over the first 2 hours of life. This is a normal part of the transition after birth. In response to a falling blood sugar level, the newborn's insulin level decreases, and glycogen is converted back into blood sugar, keeping sugar levels steady until the baby is ready to feed.
Low blood sugar problems in newborns
Even though all newborns have short-term lower blood sugar after birth as part of a normal transition, sometimes it becomes a blood sugar problem. Neonatal hypoglycemia — meaning newborn low blood sugar problem — occurs when blood sugar levels get too low, or do not improve within the first 2 hours of life.
The most common reasons low blood sugars become a problem for newborns are high insulin levels and insufficient glycogen stores. Some babies may have other genetic or metabolic conditions affecting blood sugar storage and use, but these are much less common.
Low blood sugar – is it common for newborns?
Yes. Estimates vary, but experts think as many as 25% of all newborns have blood sugar problems. If a baby has a risk factor for low blood sugar, there is about a 50% chance of having at least one episode of low blood sugar.
Some risk factors for problematic low blood sugars in newborns are:
- Maternal diabetes or gestational diabetes
- Intrauterine growth restriction or low birth weight
- Large for gestational age birth weight
- Low temperature
- Feeding problems;
- Genetic and metabolic problems
- Other medical conditions such as breathing problems
Tips for prevention of low blood sugar in newborns
It is important to know that sometimes low blood sugar will happen in babies, despite the best efforts of parents and healthcare providers. Low blood sugar problems cannot always be prevented.
- Skin to skin contact. You can help prevent low blood sugars by providing skin-to-skin contact.
- Warmth. Keep your baby warm.
- Feeding. Healthy newborns should be fed often and whenever they show interest in feeding.
Ask for help if you are having difficulty with breastfeeding.
How to treat low blood sugar in newborns?
The first treatment for low blood sugar is usually feeding the baby. A healthcare provider may also give the baby an oral gel containing sugar in addition to feeding. If blood sugar levels are too low or do not improve, a baby may need to get sugar through an intravenous (IV) fluid. Less commonly, a baby may need medications to stabilize blood sugar.
Most babies will have normal blood sugars with treatment within a few hours. However, it is not uncommon for treatment to be needed for up to 48 hours, especially if IV fluid is needed. Some babies with high insulin levels may need treatment for several days. Low birth weight babies, premature babies, or babies with other medical issues may have blood sugar problems off and on for longer.
Having a baby with low blood sugar problems can be scary for parents. However, this problem is usually better within a couple of days. Talk to your baby's healthcare provider if you have more questions about low blood sugar and your baby.
Is low blood sugar in newborns serious?
Yes, undetected and untreated low blood sugar can have serious consequences. For example, prolonged or very low blood sugars can cause temperature instability, poor feeding, pauses in breathing, and, very rarely, seizures or death. Healthcare professionals will be on alert to prevent these serious consequences by detecting and treating low blood sugars.
Can low blood sugar cause brain damage?
Rarely, very low and prolonged low blood sugars in babies can cause brain injury. Babies with severe blood sugar problems are at risk of developmental disabilities, learning disabilities, and cerebral palsy. It is important to note that these outcomes are rare. Most babies recover quickly from low blood sugars and develop normally.
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