Publication:

Incidence of hypoglycaemia within 72 hours after birth in low birth weight babies who are appropriate for gestational age

Background Neonatal hypoglycemia is a very common metabolic disorder which is due to inability to maintain a normal glucose homeostasis. The most effective method of preventing hypoglycemia is early breast feeding which is preferred to formula feeding. Therefore, author conducted this study to document incidence of hypoglycemia both symptomatic and asymptomatic in exclusively fed with breast milk, low birth weight neonates who are appropriate for gestational age. Aims and objectives of this study was to determine incidence of hypoglycaemia in first 72 hrs of life in low birth weight neonates (1500-2499gm) who are appropriate for gestational age and who are exclusively fed with breast milk.

Methods Prospective cohort study conducted in between December 2015 to November 2017 in which 150 consecutive neonates with a birth weight between 1500 to 2499 grams and appropriate for gestational age, being fed exclusively with breast milk were studied.

Results Out of 150 neonates, 36 (24%) developed one episode of hypoglycemia, 14 (9.4%) newborns had recurrent episodes while 13 (8.66%), and 1 (0.7%) newborn had two and three episodes of hypoglycemia respectively. Applying a cut-off of blood glucose level of 40 mg/dl, the incidence of hypoglycemia was 24%. The less is the gestational age there is higher chance of occurrence of hypoglycemia. PIH is the most common maternal risk factor for neonatal hypoglycemia. Incidence of hypoglycemia is highest during the first 24hrs after birth and jitteriness is the most common symptom of neonatal hypoglycemia.

Conclusions Healthy new-borns in postnatal wards can be exclusively breastfed, but there is needing to closely monitor their blood glucose levels at least in first 72 hrs and asymptomatic hypoglycaemia in new-borns can be managed with frequent breastfeeding without any formula feeds.