Hypoglycemia is a condition when the body’s blood sugar or glucose levels are too low. Not only in adults, hypoglycemia in babies can also occur.
Low blood sugar levels can cause damage to the brain .
As a result, this is something that is very concerning and becomes a concern for parents if their baby experiences hypoglycemia.
However, according to an explanation on the Indonesian Pediatrician Association (IDAI) website, momentary hypoglycemia in the early life of a full-term newborn is normal.
This will normalize on its own, as blood glucose levels increase spontaneously within 2-3 hours.
What are the signs of hypoglycemia in babies and how to deal with it? Check out the following explanation,Parents.
What is Hypoglycemia in Babies?
Quoting fromStanford Medicine Children’s Health, glucose is the main source of fuel for the brain and body.
Hypoglycemia is a condition in which a person has a lower than normal amount of glucose (sugar) in the blood.
During pregnancy, glucose is passed to the baby from the mother through the placenta . Some glucose is stored in the placenta, and then shared in the baby’s liver, heart, and muscles.
These glucose stores are important for supplying the baby’s brain with energy during labor and for nutrition after the baby is born.
In newborns, low blood sugar can occur for a variety of reasons.
What are the Symptoms of Hypoglycemia in Babies?
Reporting fromMedical News Today, not all babies with hypoglycemia have symptoms, especially in the early stages.
Therefore, many hospitals and birthing centers test blood glucose levels at birth for at-risk babies and periodically thereafter.
Most doctors consider blood glucose below 47 milligrams per deciliter (mg/dl) to be the definition of hypoglycemia in a newborn.
Here are some common symptoms that can be found in babies suffering from hypoglycemia.
- Shiver
- Blue or white discoloration of the lips and skin
- Lack of interest in breastfeeding
- Looks weak and lethargic
- Low body temperature
- Seizures
Hypoglycemia may be more severe if blood glucose continues to fall or stays low for 3 days or more.
What Causes Hypoglycemia in Babies?
1. Transitional Hypoglycemia
A drop in blood glucose is a normal part of the transition to extrauterine life and is referred to as transitional hypoglycemia.
Transitional or temporary hypoglycemia occurs because in the womb the fetus receives nutrition from the placenta through the umbilical cord.
Right after birth, the doctor will clamp and then cut the umbilical cord , reducing the baby’s glucose supply.
In some babies, this drop is too great, causing very low blood glucose.
As long as this decrease is temporary and mild, transitional hypoglycemia is not harmful to the baby.
Typically, transitional hypoglycemia corrects itself quickly when the baby begins to breastfeed regularly.
2. Malnutrition During Pregnancy
According to the bookUndernutrition during Pregnancy written by Hoang Anh Nguyen, evidence shows that women with malnutrition before and during pregnancy have an increased risk of metabolic disorders (e.g. gestational diabetes mellitus).
Also, there is a risk of complications during labor and delivery, including neonatal hypoglycemia in the baby being born.
3. Inadequate Nutritional Intake
Some babies do not get enough food at birth.
This can happen when there is a delay in feeding, when parents or caregivers do not feed early or on demand, or when there is a problem with breast milk supply .
Low blood sugar levels in newborns can occur because they have not received breast milk, where a ketogenic response occurs, namely the metabolism of fatty acids into ketone bodies.
The baby’s brain will utilize ketone bodies to conserve glucose for the brain and protect the baby’s neurological function.
In addition, babies who are breastfed tend to have lower glucose levels, compared to babies who are formula fed .
Therefore, there are many cases where babies are given formula milk because of low glucose levels, even though they actually do not need formula milk.
4. Incompatible Blood Types Between Mother and Baby
Each person’s blood has certain characteristics. If the blood of the baby and mother is not compatible, it can cause fetal anemia, immune hydrops (erythroblastosis fetalis), and other complications such as neonatal hypoglycemia.
Blood type incompatibility is a problem because a mother may develop antibodies against her baby’s blood cells, which occurs when incompatible maternal and fetal blood mix during pregnancy.
This condition can occur if the baby’s blood crosses the placenta or during certain invasive prenatal tests, trauma, birth or other situations.
5. Birth Asphyxia
According to a 2013 study , asphyxia or not getting enough oxygen during labor and perinatal stress increase the risk of hyperinsulinism in the neonatal period.
This is because the use of anaerobic metabolism to maintain blood glucose concentrations causes temporary hypoglycemia in infants.
6. Certain Medical Conditions
There are various medical conditions that can cause difficulty in breastfeeding in newborns or difficulty in absorbing and storing energy. This can be the cause of persistent hypoglycemia.
Some examples of conditions that can cause or increase the likelihood of this include:
- Congenital hyperinsulinism
- Hypothyroidism
- Galactosemia
- Fructose intolerance
- Beckwith-Wiedemann syndrome
- Soto Syndrome
- Costello Syndrome
7. Use of Antenatal Steroids
According to a 2020 study , hypoglycemia is a common side effect of the steroid drug betamethasone.
Sometimes, doctors give one type of this drug to pregnant women who are at risk of premature birth , to speed up the development of the fetus’ lungs.
Studies have found that delayed cord clamping may provide protection against these side effects in premature babies.
How is Hypoglycemia Diagnosed?
Diagnosis of neonatal hypoglycemia is made with a serum glucose test, which is a blood test that measures blood sugar in newborns.
This test, which is done by taking a blood sample from the heel, is an easy and minimally invasive method.
If blood sugar is low, your doctor will continue to monitor it to determine if treatment is needed.
Sometimes, additional tests are done to look for metabolic disorders or other diseases that can cause low blood sugar.
Treatment will depend on the gestational age at which the baby is born and the overall health of the baby.
In general, babies will be given a fast-acting source of glucose, such as a mixture of glucose and water or formula as a starter food. Glucose can also be given through an IV.
After treatment, the baby’s blood glucose levels will be checked again to see if hypoglycemia occurs again.
What are the risk factors for hypoglycemia in infants?
It has been explained that newborns can experience temporary hypoglycemia. This is regardless of the intake they receive, be it breast milk or formula.
According to IDAI, here are 3 categories of babies at risk of hypoglycemia. Pay close attention, Mom.
- Excessive glucose use, including hyperinsulinemia.
- Inadequate glucose production and reserves.
- Increased glucose utilization and decreased production.
What Kind of Baby Conditions Are at Risk for Hypoglycemia?
In addition, there are various other conditions that increase the risk of hypoglycemia in infants. Here’s the explanation.
1. Babies from Mothers with Diabetes
Mothers with uncontrolled diabetes have high blood glucose levels, which can pass through the placenta and stimulate insulin production in newborns.
At birth, the baby’s blood glucose level suddenly drops because the supply from the placenta stops. Even though insulin levels are still high, this is what causes hypoglycemia in babies.
2. Large Baby for the Pregnancy Period (BMK)
BMK babies are usually born to mothers with abnormal glucose tolerance. That is what can trigger hypoglycemia to occur.
3. Small Baby for the Pregnancy Period (KMK)
Malnutrition while still in the womb means that the baby does not have time to produce glycogen reserves, and sometimes the existing reserves are already used up.
Preterm babies have a higher metabolic rate so they use more glucose.
Even though they look fit, KMK babies often get hungry easily and need more attention.
In addition, he also needs to be breastfed every two hours, and sometimes requires supplementation and intravenous fluids while waiting for his mother’s breast milk to be sufficient.
4. Premature Babies
Glucose deposits in the form of glycogen are usually only formed in the third trimester of pregnancy.
So, if the baby is born too early, the glycogen supply will be too low and will be used up more quickly.
5. Postmature babies
Placental function in postmature or older babies has begun to decrease and glucose intake from the placenta has also decreased, so that the fetus uses its glycogen reserves.
After the baby is born, glycogen remains low, so the baby is susceptible to hypoglycemia.
6. Babies Who Are Late Given Breast Milk
Babies who are fasting, including those who are late in doing IMD, can be at risk of experiencing hypoglycemia. This is because blood glucose levels are insufficient.
7. Baby Stress During Pregnancy and Childbirth
This condition can occur, for example, if a pregnant woman experiences hypertension.
At birth, babies have a high metabolic rate and require more energy than other babies.
8. Sick
Identical twins who experience twin to twin transfusion , hypothermia, respiratory distress , endocrine abnormalities, and several other conditions can have an impact on hypoglycemia.
Therefore, check the baby’s condition with a doctor.
9. Babies born to mothers who have health problems
Mothers undergoing medication (terbutaline, propanolol, oral hypoglycemia), mothers who smoke, mothers who receive intravenous glucose during labor, can increase the risk of hypoglycemia in their babies.
Therefore, pregnant women must also maintain their health.
What are the Complications of Hypoglycemia in Babies?
Hypoglycemia means that the baby does not have enough sugar in their blood to provide enough energy to fuel the body or brain.
Transient hypoglycemia resolves quickly and is generally not dangerous.
However, severe, persistent/persistent hypoglycemia that is left untreated can lead to serious health complications.
In severe cases, neonatal hypoglycemia can affect the heart or brain and can cause seizures. There is also a risk of developmental problems.
How to Prevent It?
Transitional hypoglycemia is normal soon after birth, but certain actions can reduce the risk of hypoglycemia becoming a more persistent problem.
These include identifying babies at risk of hypoglycemia early on.
While glucose testing after birth will not prevent hypoglycemia, it can detect the condition early so treatment can be started as soon as possible and reduce the chance of dangerous complications.
Immediate feeding or breastfeeding within the first hour after birth is also recommended by experts, accompanied by a glucose test 30 minutes after the first feed for babies at high risk of hypoglycemia.
Those are some conditions that increase the risk of hypoglycemia in newborns. Hopefully it can be avoided, yes, Mom.
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