When you hear the word “sugar”, you might think of unhealthy refined sugar in food. But blood sugar, or glucose, is by no means unhealthy. It’s crucial for brain development and organ function. Low blood sugar in newborns can be dangerous.
In this article, we’ll dive into:
- Causes of newborn hypoglycemia (low blood sugar)
- Why are some babies born with low blood sugar?
- Hypoglycemia symptoms in newborns
- Treatment for babies born with low blood sugar
What is Neonatal Hypoglycemia?
That’s the “proper” term for low blood sugar in newborns. You might hear doctors refer to it as newborn hypoglycemia, infant low blood sugar, or just “NH”.
So what exactly is it? Neonatal hypoglycemia is when a baby’s glucose levels drop within a few days of birth. Specifically, it’s when blood glucose drops below 45 mg/dl in the first 4–24 hours.
NH is a fairly common condition and is often easy to treat. But left untreated, it can cause a lot of health issues for a newborn. Here’s why: the brain relies on glucose for energy. Without it, brain cells can die. This can lead to permanent brain damage.
Why Are Some Babies Born With Low Blood Sugar?
After a baby is born, it’s normal for its blood sugar to drop a tad. But doctors should monitor infants to make sure low levels go back up. Sometimes it goes back to normal through regular feeding, without special treatment.
But some babies are born with low blood sugar. Reasons for this can include:
- Prematurity
- Infections
- Fetal growth restriction
- Having a large amount of insulin in the blood. (This could be because the mother has diabetes, or because the baby is large for their gestational age. A genetic syndrome or a pancreatic tumor could also be the cause).
- The baby has a liver disease, a congenital metabolic disease, or hormone deficiencies
- Baby suffered oxygen deprivation during delivery.
- The mother’s blood type is incompatible with the baby’s, causing hemolytic disease)
Hypoglycemia is only dangerous when it persists. Severe NH is when it continues to drop and stays low for a few days or more. Doctors can diagnose NH with a simple blood test.
Causes of Newborn Hypoglycemia After Birth
After birth, a huge transition awaits newborns. They have to switch from the passive receiving of nourishment (via the umbilical cord) to active feeding. They will now get glucose from breast milk or formula. And there’s a learning curve! While they do have instincts, babies aren’t born knowing how to eat from a breast or bottle.
So a small drop in glucose is inevitable. This is called transitional hypoglycemia, and it’s normal. Once the baby starts regular feedings, levels should go back up.
But there are a few issues that could cause transitional hypoglycemia to go beyond the norm:
- Feeding problems. (A delay in feeding, not feeding on demand, breastmilk supply problems).
- Medical problems that cause feeding issues or problems absorbing energy. (Eg.: hypothyroidism, fructose intolerance, Costello syndrome).
- Steroid medications. (Betamethasone, a steroid drug that aids fetal lung development, can cause low blood sugar in newborns).
Hypoglycemia Symptoms in Newborns
The symptoms of hypoglycemia in newborns can vary. But here are some common signs to watch for:
- Jitteriness or tremors. The baby might shake a little or have uncontrolled movements of their hands and feet.
- Poor feeding. Babies born with low blood sugar may have difficulty latching. They tend to be fussy or irritable during feeding.
- Lethargy or sleepiness. The baby may seem excessively tired or be difficult to wake up.
- Cyanosis or paleness. The skin or lips may appear bluish or pale, indicating a lack of oxygen.
- Respiratory distress. Babies with NH may breathe rapidly or have difficulty breathing.
- Apnea. This is when a baby stops breathing for short periods of time.
- Hypothermia. Babies with NH may have a lower body temperature than normal.
- Seizures. Hypoglycemia symptoms in newborns with very low glucose levels could include seizures or convulsions.
Some babies born with low blood sugar don’t show any symptoms at all. This is why most hospitals test blood glucose at birth. They should continue to test on a regular basis if the infant is at risk for hypoglycemia.
Treatment for Babies Born with Low Blood Sugar
Most of the time, low blood sugar can be prevented by making sure the baby eats soon after birth. By “eat”, we don’t mean a 3-course meal.
The baby should breastfeed or drink formula. Feeding formula on a schedule and breastfeeding on demand can help ward off the risk of hypoglycemia. But sometimes babies born with low blood sugar have a hard time getting their glucose levels back up. In that case, doctors might prescribe further treatment, such as:
- Giving a mixture of glucose and water, or an oral sugar gel
- Providing glucose through an IV
- Glucagon injections
- A stay in the ICU for monitoring
Of course, if a baby develops complications from hypoglycemia, doctors will have to address those too. Next, we’ll talk about what those complications may be.
Complications of Low Blood Sugar in Newborns
When doctors pay attention to hypoglycemia symptoms in a newborn, the outlook will often be good. It’s when the signs are ignored that things can go south.
Babies born with low blood sugar can develop long-term or permanent injuries if they don’t receive treatment on time. These include:
- Impaired vision
- Brain injuries
- Cerebral palsy
- Learning disabilities
- Metabolic disorders
- Growth and development issues
- Cognitive and behavioral problems
- Neonatal morbidity
NH Complications and Medical Negligence
Catching hypoglycemia symptoms in newborns is often simple. Even if there are none, doctors can diagnose low blood sugar in newborns with a simple test. There are also known risk factors for hypoglycemia that doctors can watch out for.
That means there’s no excuse for letting hypoglycemia get out of hand. If a doctor fails to treat it, that’s negligence. If they are aware a child is at risk of low glucose levels and do not test, that’s also negligence.
A study published in the National Library of Medicine sheds some light on where doctors go wrong. Here are the “ deficits of care” that researchers found led to NH-related injuries (and subsequent lawsuits):
- Failure to start blood glucose monitoring when there were identifiable risk factors
- Early discharge of baby, despite risk factors
- Insufficient advice to mother on discharge
- Ignoring maternal concerns
- Failure to recognize, document, and assess abnormal clinical signs, including abnormal feeding behavior
- Delayed testing for blood glucose level and/or to obtain results after clinical signs identified
- Delayed appropriate action for low blood glucose result
- Not giving a necessary referral for medical review
- Delayed medical review after referral
- Admission to the neonatal unit too late
- Delayed administration of intravenous glucose
- Insufficient intravenous glucose delivery
Legal Help for Babies Born with Low Blood Sugar
Is your child suffering from long-term effects of hypoglycemia? You may be able to file a medical malpractice lawsuit. Of course, your next question might be, “Where do I start?”
You can begin by talking to expert birth injury lawyers to see if you have a case. We’ll listen to your story and tell you whether it’s in your best interest to sue. We invite you to schedule a free consultation here.
Hampton & King has helped thousands of families recover millions of dollars in damages. These awards are not only what they deserve, but what they need in order to give their children the best lives possible. Click here to see our birth injury case results.
