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Neonatal Hypoglycemia is a condition that can cause damage to the brain and subsequent physical and mental impairment. There is an increased risk shortly after birth for children of insulin dependent mothers, babies with growth retardation, preterm and asphyxiated infants. Doctors often do not recognize the symptoms of neonatal hypoglycemia and as a result do not take appropriate action to prevent brain damage.
Hypoglycemia - Medical Malpractice
Neonatal hypoglycaemia is low blood sugar or low blood glucose in the first hours or days of life. It is a problem common to women who have diabetes, women who have gestational diabetes and women who have very large infants. Glucose normally provides the body energy and is the only energy source for the brain. Glucose is necessary to make sure the brain gets the nutrition it needs.
Glucose in utero is given through the placenta. The mother's bloodstream is filled with glucose that passes through the placenta and is processed via the infant's pancreas, which makes insulin in response to the sugar it gets. This normalizes the infant blood sugar even if the mother's blood sugar is high. When the infant is finally born, its pancreas is still going at a rate expecting a high blood sugar to be presented to it. This doesn't happen after the baby is born and the overactive pancreas lowers the blood sugar to dangerous levels. The baby needs some kind of glucose to counteract the elevated insulin levels in the baby. This lets the pancreas slowly normalize its overdriven rate.
Fortunately, infant formula is turned into glucose by the liver enzymes so that feeding the infant shortly after birth can take care of the problem quite quickly. If you need to treat a moderately low blood sugar, infant formula is a good treatment. If the problem is severe, oral or IV glucose is given instead.
The causes of neonatal hypoglycaemia can also be due to an enlarged pancreas in the neonate or due to poor glycogen stores in the liver. Glycogen is the way glucose is stored in the infant's liver. The baby could be ill and could be using too much glycogen to fight the illness and will have low glucose levels.
Neonatal hypoglycaemia is the most common metabolic problem in neonates. It is seen to a severe degree in 1 to 3 out of a thousand births and is seen in milder cases in many more cases.
The following conditions can lead to neonatal hypoglycaemia: bloodborne infection, intrauterine growth retardation, hypothyroidism, low oxygen during delivery, inborn errors of metabolism, large infant, gestational diabetes, diabetes type I or II in the mother, prematurity in the infant or if the baby is too small for its gestational age.
When a neonate has neonatal hypoglycaemia, nurses can note several symptoms that indicate the possibility of neonatal hypoglycaemia. There can by cyanosis or bluish coloration to the skin; there can be difficulty breathing; there can be a floppy baby with poor muscle tone; the baby may be grunting when breathing or ca be overly irritable. There may be poor feeding with a rapid breathing that is shallow in nature. The baby is often tremulous or shaking of the body along with seizures or sweating noted. The baby may also be listless and pale and may be breathing in an irregular pattern.
The blood sugar is checked any time a low blood sugar situation is suspected. If the blood sugar is lower than 40 mg/dL, the situation is neonatal hypoglycaemia. If it is less than 20 mg/dL, it is often read as "low" on a glucose monitor and immediate action needs to be taken, including IV glucose administration. Doctors need to check for the underlying cause of the disease, including inborn errors of metabolism or perhaps hypothyroidism.
If the situation is mild, the infant is given oral glucose water, oral breast milk or oral formula in order to bring up the blood sugar. IV glucose is reserved for severe cases when the infant doesn't have the ability to eat on its own. It takes several hours to treat neonatal hypoglycaemia before the infant glucose level normalizes and stays normal. It should be rechecked every few hours until it stabilizes into the normal range. Two medications can be used in severe cases. These include ocreotide or diazoxide. Diazoxide causes an increase in blood sugar levels and ocreotide lowers the insulin levels.
Prolonged low blood sugar can be dangerous and can result in seizures, heart failure and developmental delay. This is why doctors and nurses need to check the blood sugar if there are any symptoms or clinical evidence that low blood sugar might exist.LEGAL HELPLINE: ☎ 855 804 7125