Who are smaller in size than normal for their gestational age
Infants with low blood sugar may not have symptoms. After birth, nurses in the hospital will check your baby's blood sugar levels, even if there are no symptoms.
If they do occur, symptoms may include:
Bluish-colored or pale skin
Breathing problems, such as pauses in breathing (apnea), rapid breathing, or a grunting sound
Irritability or listlessness
Loose or floppy muscles
Poor feeding or vomiting
Problems keeping the body warm
Tremors, shakiness, sweating, or seizures
Signs and tests
Newborns at risk for hypoglycemia should have a blood test to measure blood sugar levels every few hours after birth. This will be done using a heel stick. The health care provider should continue taking blood tests until the baby’s glucose level stays normal.
Other possible tests:
Newborn screening for metabolic disorders
Infants with low blood sugar levels will need to receive extra feedings with breast milk or formula. Babies who are breast-fed may need to receive extra formula until the mother is able to produce enough breast milk.
The baby may need a sugar solution given through a vein (intravenously) if he or she is unable to eat by mouth, or if the blood sugar is very low.
Treatment will be continued for a few hours or days to a week, or until the baby can maintain blood sugar levels. Infants who were born early, have an infection, or were born at a low weight may need to be treated for a longer period of time.
If the low blood sugar continues, in rare cases the baby may also receive medication to increase blood sugar levels. In very rare cases, newborns with very severe hypoglycemia who don't improve with treatment may need surgery to remove part of the pancreas (to reduce insulin production).
The outlook is good for newborns who do not have symptoms or who respond well to treatment. However, low blood sugar levels can return in a small number of babies after treatment.
The condition is more likely to return when babies are taken off intravenous feedings before they are fully ready to eat by mouth.
Babies with more severe symptoms are more likely to develop problems with learning. This is especially true for babies who are at a lower-than-average weight or whose mother has diabetes.
Severe or persistent low blood sugar levels may affect the baby's mental function. In rare cases, heart failure or seizures may occur.
If you have diabetes during pregnancy, work with your health care provider to control your blood sugar levels. Be sure that your newborn's blood sugar levels are monitored after birth.
Adamkin DJ and Committee on Fetus and Newborn. American Academy of Pediatrics clinical report - postnatal glucose homeostasis and late-preterm and term infants. Pediatrics. 2011;127:575-579.
Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.