Neonatal Hypoglycemia (low Blood Sugar) And Birth Injury
Glucose is crucial to brain development, as it is one of the only sources of energy the brain can use. Neonatal hypoglycemia is a condition in which a baby’s blood sugar falls very low within a few days after birth. These low glucose levels impair the growth process, and brain cells start to die. Neonatal hypoglycemia is one of the most common neonatal metabolic issues, and one of the most easily treated. Infants with neonatal hypoglycemia (NH) experience a dangerous drop in their level of glucose (also known as blood sugar) in the first few days after birth. Babies need glucose for energy, and most of the glucose is used by the brain. Before birth, the baby gets glucose from the mother through the placenta. After birth, the baby gets glucose from breast milk or formula. Glucose is also produced in the baby’s liver. Neonatal hypoglycemia is one of the most common metabolic problems in babies, and severe NH is one of the leading causes of brain injury. Neonatal hypoglycemia is not difficult to recognize, and usually it is very easily treated. Untreated NH, however, can have serious consequences because an infant’s developing brain tissue depends on a steady supply of glucose as its main source of fuel. When brain cells receive insufficient glucose, they start to die. Risk Factors for Neonatal Hypoglycemia There are some medical conditions that make low blood sugar levels more likely in some infants. These include: Babies who are small or macrosomic (large) for gestational age Preterm and postterm babies Babies who were born to diabetic mothers Babies who have a serious infection or who needed oxygen right after delivery Babies who had poor growth in the womb during pregnancy Babies with low thyroid hormone levels (hypothyroidism) Babies who have certain rare geneti Continue reading >>
Causes Of High Blood Glucose And Low Blood Glucose
Low or high blood sugar in a child with diabetes can cause loss of responsiveness. All of the cells in our body depend upon sugar in our blood as the main source of energy. This sugar comes from the foods that we eat. Certain organs in our body also make and store sugar. When the body is working properly, it automatically regulates the amount of sugar in the blood. When there is too much sugar in the blood, the body makes insulin, which lowers blood sugar. When blood sugar levels are too low, the body cuts back on the amount of insulin that it is making and lets the blood sugar levels rise. When blood sugar levels in the body are lower than normal, a child has hypoglycemia. Signs of hypo-glycemia in a healthy child are usually mild, such as irritability. In a child with diabetes, hypoglycemia can lead to loss of responsiveness if not treated quickly. A diabetic child can get hypoglycemia if he doesn’t eat enough or doesn’t eat at the right time. He can get hypoglycemia if he takes too much insulin. Blood sugar levels may drop because of exercise, being overheated, or illness. A diabetic child may have too much sugar in the body. This is called hyperglycemia. It is the opposite of hypoglycemia. This condition may be caused by too little insulin, illness, or stress. It may be caused by overeating, inactivity, or a combination of all of these factors. If you are not sure if the child has hypoglycemia or hyperglycemia, give sugar. See if the symptoms improve. Always call EMS if symptoms are severe or if the child becomes unresponsive. Signs of Hypoglycemia and Hyperglycemia Signs of Hypoglycemia Signs of Hyperglycemia Irritability Paleness Drowsiness Confusion Trembling Excessive Sweating Poor coordination Slurred speech Staggering Eventual loss of responsivene Continue reading >>
Low Blood Sugar In Newborns Tied To Brain Problems Later
Low blood sugar affects about one in six newborns, and new research suggests it could lead to brain difficulties in childhood. Babies who experience low blood sugar at or near birth are at least two to three times more likely to face problems with planning, memory, attention, problem-solving and visual-motor coordination by the age of 4.5, New Zealand researchers said. The low blood sugar (glucose) did not affect general thinking function or IQ, but it did affect problem-solving and other skills known as “executive functioning,” and also eye-hand coordination, the findings showed. These are crucial for many tasks, said study leader Chris McKinlay. He is a neonatologist at the Liggins Institute at the University of Auckland. “We don’t know fully what this means for learning,” McKinlay said. “We think this may have an effect on educational achievement.” Low blood sugar in newborns, known as “neonatal hypoglycemia,” is the most common preventable cause of brain damage in infancy. Those at risk of low blood sugar include babies born prematurely, those small or large for their gestational age, and those born to mothers with diabetes. For these high-risk infants, it is common to do a blood glucose test, using a heel prick. If the level is too low, the child can be treated with a form of sugar to return it to normal levels. Join the conversation and share this story In the study, McKinlay’s team followed 477 infants who were born between December 2006 and November 2010. About half of the babies were diagnosed with low blood sugar at birth and treated. Most of those in the study received continued monitoring of the blood sugars; some infants whose low blood sugar was not detected at birth turned out to have it later. At a follow-up at the age of about 4.5 ye Continue reading >>
Hypoglycemia In Newborns
Neonatal hypoglycemia occurs when a newborn has low blood sugar levels in the first few days after birth. It occurs in about 1-3 out of every 1,000 births. A normal blood sugar level, also known as glucose, is crucial for a baby’s energy and brain development. Severe or prolonged hypoglycemia may result in seizures and serious brain injury. During pregnancy, the baby gets all nutrients, including glucose from the mother, through the umbilical cord in a constant stream. At birth, the umbilical cord is clamped then cut effectively removing the baby’s source of nutrients. Most babies have glucose stored in the liver, which helps maintain a normal blood sugar until the baby begins to nurse. Colostrum, the very early milk produced by a mother is very high in glucose. Some babies have difficulty producing enough glucose to maintain their blood sugar levels prior to nursing. Glucose levels can drop if there is too much insulin in the blood, if the body is not producing enough glucose, if it is using more than can be produced, and if the baby is not feeding enough to keep the glucose levels up. For example, low glucose levels are more common for infants who: Were born prematurely or are under significant stress such as having difficulty breathing or when they are battling an infection. The premature liver does not have adequate glucose stores to support a normal blood sugar for long if at all. The stressed newborn metabolizes glucose faster than a healthy full term baby. Have a mother with diabetes due to over production of insulin. Have low thyroid hormone levels (hypothyroidism) Had poor growth in the womb again because the liver did not adequately store glucose prior to delivery. Infants with low blood sugar don’t always show symptoms. But nurses and doctors know to ch Continue reading >>
Hypoglycaemia In Babies
What is hypoglycaemia? Hypoglycaemia means low blood sugar. If your baby's blood sugar is low, and it is not treated, it could put his health at serious risk. If it stays low for a long time, it even could cause brain damage. However, if your baby is not premature, and otherwise healthy, he is unlikely to have low blood sugar. Don't worry if he is at risk of having low blood sugar. A host of medical professionals will be on hand to make sure that your baby's health is safeguarded. After he's born, your midwife and other staff will make sure that he is feeding well. They will check your baby's glucose level with a blood test if they are worried. In some hospitals, these blood tests are routinely offered to babies who are thought to be at high risk. What causes hypoglycaemia in newborns? Every cell in the body needs a supply of sugar, or glucose, to function well. We get glucose from the foods we eat and newborn babies get it from milk. Keeping the right level of sugar in the blood is a delicate balancing act. After we eat a meal, or when babies have just had a feed, sugar levels go up. When it is time for the next feed, levels start to dip. Sugar levels are regulated by our hormones, particularly insulin, which helps certain cells take up glucose for storage. When everything is working well, the hormones keep the blood sugar levels within an even range. When the balance is out, hypoglycaemia can happen. Your baby's blood sugar levels go down in the first few hours after birth and this is normal. Most healthy babies can cope easily with normal dips in blood sugar level. If they're given breastfeeds whenever they want, they will take the milk they need to ensure their sugar levels remain healthy. However, some babies are at risk, including babies born to mothers who have d Continue reading >>
Hypoglycemia In Infancy
WHAT YOU NEED TO KNOW: What is hypoglycemia? Hypoglycemia is a condition that causes your infant's blood glucose (sugar) level to drop too low. When your infant's blood sugar level drops too low, his brain cells and muscles do not have enough energy to work well. Glucose is needed to help an infant's brain grow normally. Hypoglycemia may be short-term or ongoing. What increases my infant's risk for short-term hypoglycemia? Your infant was born earlier than expected (before 37 weeks of pregnancy). Your infant was born at a low birth weight and length. Your infant's body makes too much insulin. Insulin is a hormone that moves glucose out of the blood stream and into the cells to be used for energy. This condition is called hyperinsulinism. Infants born to a mother who has diabetes or had toxemia while she was pregnant are at risk for this condition. Toxemia is high blood pressure and protein in the urine. What causes ongoing hypoglycemia in infants? Hyperinsulinism caused by a genetic disorder (a disorder that an infant is born with) Low levels of certain hormones Problems with the way your infant's body uses glucose Medical conditions such as ketotic hypoglycemia (the body changes fats into glucose for energy) What are the signs and symptoms of hypoglycemia in infants? Signs and symptoms may be mild and not easily seen. Newborns may not have any symptoms at all. Your infant may have any of the following: Breathing that stops for short periods of time Blue or purple skin color Low body temperature Problems eating well Seizures Sluggish or drowsy behavior How is hypoglycemia diagnosed? Healthcare providers will ask about your infant's symptoms and family health history. They may ask about the amount of time between your infant's last meal and the start of his symptoms. The Continue reading >>
Hypoglycemia In Newborns
What is hypoglycemia? Hypoglycemia means low blood sugar. If your baby's blood sugar is low, and it is not treated, it could put his health at serious risk. If it stays low for a long time, it even could cause brain damage. Certain factors put babies at higher risk of having hypoglycemia including being born prematurely, being small or large for gestational age (the smallest and largest 10 per cent of babies), having a diabetic mom, and being sick. However, if your baby does not have one of these risk factors, and is otherwise healthy, he is unlikely to have low blood sugar. Don't worry if he is at risk of having low blood sugar. A host of medical professionals will be on hand to make sure that your baby's health is safeguarded. After he's born, your midwife or doctor will make sure that he is feeding well. They will check your baby's glucose level with a blood test if they are worried. In some hospitals, these blood tests are routinely offered to babies who are thought to be at high risk. What causes hypoglycemia in newborns? Every cell in the body needs a supply of sugar, or glucose, to function well. We get glucose from the foods we eat and newborn babies get it from milk. Keeping the right level of sugar in the blood is a delicate balancing act. After we eat a meal, or when babies have just had a feed, sugar levels go up. When it is time for the next feed, levels start to dip. Sugar levels are regulated our hormones, particularly insulin, which helps certain cells take up glucose for fuel. When everything is working well, the hormones keep the blood sugar levels within an even range. When the balance is out, hypoglycemia can happen. It’s normal for your baby's blood sugar levels go down in the first few hours after birth because your baby is separated from the sup Continue reading >>
Hypoglycæmia Of The Newborn (low Blood Sugar)
Introduction The fear of low blood sugar of the newborn has become the new “acceptable” reason to separate mothers and babies and give babies supplements of formula in the immediate hours and days after the baby’s birth. The reason paediatricians and neonatologists are worried about low blood sugar is that it can cause brain damage, so there truly is a concern. However, there has developed a sort of ‘hyper’-concern about low blood sugar that is simply not warranted. As a matter of fact, most of the babies who are tested for low blood sugar do not need to be tested and most of those who receive formula do not need formula. By giving the formula, especially as it almost always is given by bottle, we interfere with breastfeeding and give the impression that formula is good medicine. Some truths about hypoglycæmia of the newborn The best way to prevent low blood sugar is to feed the baby with milk. However, formula and breastmilk (specifically colostrum in these early days) are not equivalent and colostrum is far better to prevent and treat low blood sugar than formula (See point #5 below). A little bit of colostrum maintains the blood sugar better than a lot of formula.1,2,3 Having the baby skin to skin with the mother immediately after birth maintains the baby’s blood sugar higher than if the baby is separated from her. (See the information sheet The Importance of Skin to Skin Contact). There is no lowest level of blood sugar that is universally accepted as meaning the baby has low blood sugar. Because of this atmosphere of hyper-concern about low blood sugar, the level of sugar keeps being raised to absurd levels. In many hospitals now, 3.4 mmol/L (60 mg %) is now considered the lowest acceptable blood sugar. This is patently aberrant and there is no evidenc Continue reading >>
Large Newborn With Low Blood Sugar
“I had an LGA baby born one week early at 10lbs10oz. She was large and breech, I had to have her via c-section. At two months she is 15lbs and 24 inches I did not have gestational diabetes, my husband and I are not big. Big babies do not run in our families. She does not have thyroid issues, they already checked. Why do large babies have low blood sugar when they are born? She also had jaundice that took 6 days to lower enough to get her out of hospital.” Most large babies burn more energy than average babies. This is mainly because their metabolism is just a little higher. Why is this? Gestational diabetes is one cause. Also, simple genetic differences in people will cause a newborn to be a little larger, and whatever was causing this baby to be larger, will also cause the metabolism to be just a little higher. However, in the first few days of life, they are still getting the same amount of nutrition from mom as a smaller baby would, so they can be prone to low blood sugar. A baby’s liver is responsible for helping the body utilize energy, so any immaturity of the liver could also cause a baby to have a low blood sugar. An immature liver will also cause a baby to be more jaundiced than normal – so this is probably why your baby had both a low blood sugar, and jaundice severe enough to require extended phototherapy. Bottom line: not much you could have done to predict this. It is considered a minor complication of being a large newborn, and most babies work through it easily with minimal help from the doctors. Continue reading >>
Bogus Neonatal Low Blood Sugar Derails Hospital Breastfeeding
Most expectant Mothers who intend to breastfeed their newborns are aware that giving birth in the hospital runs the risk of having your baby get a bottle of sugar water (aka “baby crack”) by a well intentioned but seriously misguided nurse, perhaps to pacify a fussy baby in order to let Mom sleep. Another reason a newborn may be given sugar water is for “pain management” when the baby receives the synthetic vitamin K shot, the liver damaging Hep B jab or newborn screening tests involving a heel prick. Besides the fact that this sugar water contains glucose derived from genetically modified (GMO) corn, giving a baby an artificial nipple before breastfeeding is established is a great threat to the future breastfeeding relationship between Mom and baby. As a result, clued in Moms are now advised to include a “no sugar water” clause in their birth plans, with doulas and other birthing advocates remaining watchful while Mom is resting or baby is out of the room for whatever reason. Now, there is a new game in town that is commonly being used to derail breastfeeding after a hospital birth and arbitrarily give GMO laced commercial formula to babies. This reason is neonatal hypoglycemia or low blood sugar. I first became aware of this problem when a friend sent me an email about it. She had been made aware of the situation by a doula from New Mexico who said that women who start off breastfeeding in the hospital are being told by the nurses that their babies have low blood sugar and they need to have formula right away. This misguided advice caused a large number of mothers to stop breastfeeding out of concern that neonatal hypoglycemia might cause harm such as brain damage. So what’s the truth? Do babies ever need formula instead of rich, immunity building colost Continue reading >>
Treating Low Blood Sugar Prevents Brain Damage In Newborn Babies: Study
Stabilising blood sugar levels in newborns with hypoglycemia, or low blood sugar, appears to prevent brain damage, according to the first study of its kind. The study, led by the Liggins Institute at the University of Auckland in New Zealand, is published today in The New England Journal of Medicine. It was funded by the National Institutes of Health in the United States and the Health Research Council of New Zealand. The lead researcher, Distinguished Professor Jane Harding, says the study shows that if doctors treat a baby with hypoglycemia to keep the blood sugar above a safety threshold, there is no increase in the risk of brain damage. This threshold, already widely used, is 2.6 millimoles per litre or 47 milligrams per decilitre. The study has also found that babies with blood sugar levels that were higher than usual appeared to be at risk of brain damage. “Hypoglycemia is the single most preventable cause of brain damage in newborns. Up to 30 per cent of newborns are at risk, 15 per cent will be affected to at least some degree, and around 10 per cent end up admitted to intensive care,” says Professor Harding. “We know that a baby with a blood glucose level that is too low for too long will suffer neurological damage, but there has been debate about just how low, for how long, and in which babies. This is the first clear evidence that treating babies to keep their blood sugar above a widely-used safety intervention threshold does indeed protect them.” The Liggins Institute researchers - working with other colleagues at the University of Auckland and the University of Waterloo - also found that babies who had blood glucose levels that rose too high or which fluctuated widely during the first 48 hours of their lives were more likely to have brain damage. Continue reading >>
I Have Gestational Diabetes. How Will It Affect My Baby?
Will gestational diabetes hurt my baby? Most women who develop diabetes during pregnancy go on to have a healthy baby. Dietary changes and exercise may be enough to keep blood sugar (glucose) levels under control, though sometimes you may also need to take medication. But untreated gestational diabetes can cause serious problems. If blood sugar levels remain elevated, too much glucose ends up in the baby's blood. When that happens, the baby's pancreas needs to produce more insulin to process the extra sugar. Too much blood sugar and insulin can make a baby put on extra weight, which is stored as fat. This can make the baby grow very large (macrosomia). Also, high blood sugar levels during pregnancy and labor increase the risk of a baby developing low blood sugar (hypoglycemia) after delivery. That's because the baby's body produces extra insulin in response to the mother's excess glucose. Insulin lowers the amount of sugar in the blood. The signs and symptoms of hypoglycemia in an infant include: jitteriness weak or high-pitched cry floppiness lethargy or sleepiness breathing problems skin that looks blue trouble feeding eye rolling seizures A baby may also be at higher risk for breathing problems at birth, especially if blood sugar levels aren't well controlled or the baby is delivered early. (If you have gestational diabetes, your baby's lungs tend to mature a bit later). The risk of newborn jaundice is higher too. If your blood sugar control is especially poor, the baby's heart function could be affected as well, which can contribute to breathing problems. Gestational diabetes sometimes thickens a baby's heart muscle (hypertrophic cardiomyopathy), causing the baby to breathe rapidly and not be able to get enough oxygen from her blood. It's understandable to feel anxi Continue reading >>
Pregnancy: High-normal Blood Sugar Risky
May 7, 2008 -- Babies born to women with even slightly higher-than-normal blood sugar levels are at increased risk for a range of pregnancy and delivery-related complications, findings from an international study confirm. The large study examined the risks associated with having elevated blood sugar during pregnancy that is not high enough to be considered gestational diabetes. More than 25,000 pregnant women from nine countries took part in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, which appears in the May 8 issue of The New England Journal of Medicine and was largely funded by the National Institutes of Health. Even a small rise in blood sugar above what is considered normal was associated with an increase in adverse outcomes, including high birth weight, C-section delivery, and preeclampsia, a complication that can lead to premature birth and can be deadly if not treated. The findings make it clear that elevated blood sugar has a direct negative impact on pregnancy and delivery, study co-author Donald R. Coustan, MD, tells WebMD. Coustan is professor and chairman of obstetrics and gynecology at Brown University Medical School. "This lays to rest many of the criticisms about gestational diabetes treatment," Coustan says. "The critics have said that it isn't elevated glucose that leads to negative outcomes, it is obesity or maternal age or some other risk factor. But we were able to control for these risk factors, and glucose was still a major determinant of outcomes." Who Should Be Treated? One important question that remains unanswered is whether the threshold for treating high blood sugar in pregnancy should be lowered and if so, by how much. "Because there was a continuous relationship that was even seen in women with glucose levels considered n Continue reading >>
Gestational Diabetes And Your Baby's Health
Insulin, a hormone produced by your pancreas, is necessary to move glucose (or sugar) into your cells after your body breaks down food for energy. During pregnancy, your body becomes less sensitive to the effects of insulin, which can lead to what’s known as gestational diabetes. If you have gestational diabetes, your blood sugar can become too high, creating a number of health risks for your baby. Gestational Diabetes and Your Baby's Health If your blood sugar remains consistently elevated during pregnancy, the excess sugar can pass through your womb to your unborn baby. This can increase your child’s future risk of obesity and type 2 diabetes. Other health risks associated with gestational diabetes include: Macrosomia. This term simply means "big baby" and applies to any baby whose birth weight is above 8 pounds, 13 ounces. A baby with macrosomia can experience difficulties during the childbirth process. The most common problem that big babies encounter is damage to the nerves and muscles in their shoulders during vaginal delivery. Your doctor will monitor the size of your baby by performing ultrasound exams throughout your pregnancy. If your doctor is concerned about the size of your baby, a Caesarean section may be recommended. Hypoglycemia. If your unborn baby is exposed to high blood sugar levels while in the womb, the baby will eventually make extra insulin on its own to deal with the excess sugar. This surge in insulin can cause the baby's glucose to drop sharply right after birth, a condition called "hypoglycemia." Low blood sugar is dangerous because your baby depends almost exclusively on glucose for energy at the time of birth. Signs and symptoms of hypoglycemia include seizures, sluggishness, and difficulty breathing. For this reason, doctors will check Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- diabetes: Gestational diabetes is a more serious problem in India than in other parts of the world: Dr Nam Han Cho, Health News, ET HealthWorld
- The Surprising Link Between Your Sleep and Gestational Diabetes
Treating Low Blood Sugar In Newborns
At a Glance Treating low blood sugar (glucose) in newborns at the currently recommended threshold level was safe and appeared to prevent brain injury. More work will be needed to determine how best to tailor the treatments to maintain blood glucose levels at a stable, safe range. A newborn’s brain relies on glucose to fuel development. Low blood glucose levels (hypoglycemia) at birth have been associated with brain injury and intellectual and developmental disabilities. Infants are typically screened at birth for low blood glucose, which is common and easily treated. However, clear evidence to support a specific threshold for hypoglycemia treatment has been lacking. An international team led by Dr. Jane E. Harding of the University of Auckland, New Zealand, examined the relationship between glucose concentrations in newborns and subsequent brain function at 2 years of age. The research was funded in part by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Results appeared on October 15, 2015, in the New England Journal of Medicine. The researchers followed 404 newborns at a hospital in New Zealand. All were born at risk of hypoglycemia, mainly because the mother had diabetes, the birth was preterm (before 37 weeks), or the birth weight was very low or very high. Of the infants, 216 (53%) had blood glucose levels less than 47 milligrams per deciliter (mg/dl), which is a well-accepted threshold for hypoglycemia. These infants were treated with a combination of additional feedings and oral or intravenous glucose to maintain their blood sugar above this threshold. Hospital staff periodically monitored the infants’ blood glucose for up to 48 hours. The researchers also fitted the infants with a device that continuously moni Continue reading >>
