Everything you need to know about hypoglycemia in newborns.
What is hypoglycemia?
Put simply hypoglycemia means low blood sugar. Your baby’s blood sugar levels are regulated by the hormone insulin, just like everyone else. Insulin helps the body to store sugar and release it as energy when your body needs it. When everything is working well, your baby’s hormones should keep their blood sugar levels normal. When the delicate balance is out, hypoglycemia in newborns can occur.
If your baby has levels of blood sugar that are too low left untreated it can be detrimental to their health. This goes the same for if their blood sugar levels are too high. If low blood sugar levels in your baby aren’t picked up it can lead to the worst case scenario of your baby’s brain being damaged. This is one of the reasons your doctor or midwife will monitor your baby’s blood sugar levels closely. Rest assured though, if your baby is not premature and is otherwise healthy, the risk of hypoglycemia is much lower.
What causes hypoglycemia in newborns?
In the first few hours after birth, your baby’s blood sugar levels will naturally drop, which is completely normal. Your newborn gets all of their nutrients, glucose included, from milk. When your baby has just been fed their blood sugar levels will rise, and dip as they digest their milk. Keeping your newborn’s blood sugar levels at the right ratio is a delicate balancing act.
Most babies are able to cope easily with these completely normal rises and dips in their blood sugar levels. If you feed your baby on demand, they will be able to take the milk they need to ensure their levels remain balanced.
Some babies can be at risk for hypoglycemia, including babies born to mothers who have diabetes. These babies may produce too much insulin when they are born, which makes them more prone to lower blood sugar levels.
Newborns who are more at risk to hypoglycemia include those who:
- were born very small or prematurely
- have suffered excessive coldness or hypothermia
- had difficulty breathing at birth
- had an infection
If you find that your newborn has hypoglycemia, it can usually be easily reversed. Once your baby is born, your midwife and other staff will ensure they are feeding well. If they are worried, they will check your baby’s blood glucose levels. These blood tests are routinely available at some hospitals for babies who are thought to be at a higher risk.
How can I tell if my newborn has hypoglycemia?
Often you can tell if your baby has hypoglycemia just by watching them. If your baby’s blood sugar levels are too low there may be some subtle signs. They could be irritable, or very sleepy and floppy. It’s hard to know what’s normal when you’re first getting to know your baby, so don’t hesitate to ask your midwife to check up on them for you. Even if it isn’t hypoglycemia, your baby might be showing signs of discomfort for another reason.
If your baby’s blood sugar levels are extremely low, they may start fitting or going into convulsions. These are the signs that something very serious is happening and you need to call an ambulance.
The only way to find out for sure what your baby’s blood sugar levels are is to get a blood test. The midwife will take a pinprick of blood, usually from the bottom of your baby’s foot. It’s a quick procedure and shouldn’t upset your baby too much. Every hospital has their own policy for blood glucose testing in newborns. Doctors don’t always agree on what a ‘safe level’ of blood sugar is in newborns.
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What is the treatment for hypoglycemia?
If hospital staff are worried about your baby’s blood sugar levels, the first thing they may ask you to do is try to feed your baby. They will nearly always try to get you to breastfeed if possible. They will encourage you to keep your baby close, preferable with skin-to-skin contact. This contact will encourage your baby to feed and will also keep them warm, which lowers the risk of hypoglycemia in newborns.
If your baby is having difficulty latching, they can still have your breastmilk. The nurses or midwife may encourage you to express your milk. You can then feed your baby from a bottle. If your baby is still having trouble latching to the bottle then the midwife may gently insert a soft, flexible tube through your baby’s nose and down to their stomach. This may be very difficult and upsetting for you to have to witness, but hopefully, you will be reassured that your baby is getting the feed they need.
The nurses and midwives will always tell you that breastmilk is best, however, if you can’t express milk, don’t blame yourself. Your baby will most likely be given a top up of formula milk to keep their blood sugar levels up. If you are breastfeeding your baby and their levels are still a bit low, the staff may suggest topping up with formula. They should be able to talk you through all the benefits and how important it is that your baby is fed.
There is a lot of stigma around parents who chose to formula feed. Yeas, we’ve all heard the mantra of ‘breast is best’, but in reality, FED is best. Do what’s right for you and your baby.
If, after feeding, your baby’s blood sugar levels are still low they may be seen by a pediatrician who will give them a sugar solution, or glucose, through a drip. Once your baby’s blood sugar levels have stabilized they can gradually come off the drip as they start taking feeds again.
If your baby does not respond well to the treatment, or if the hypoglycemia is re-occurring, your doctor should recommend tests to find out if there is a medical condition causing it.
Can I still breastfeed if my newborn has hypoglycemia?
If your baby has hypoglycemia, it doesn’t mean there is anything wrong with your breastmilk. If your baby isn’t feeding for a while because they are on a drip, try to keep your milk flow going, so they can breastfeed when they come off it. Some ways of doing this include expressing your milk by hand frequently, holding your baby close with skin-to-skin contact if possible also helps.
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If you want to breastfeed but are struggling, try to find support.