Hypoglycaemia in newborns.

1. Big picture

Neonatal hypoglycaemia is one of the most important metabolic problems in the newborn period because the newborn brain depends heavily on glucose, and symptoms can be subtle or absent.

The examiner wants you to recognize this pattern:

Jittery, lethargic, poorly feeding, apneic, cyanotic, or seizing newborn = check blood glucose immediately.

The most important rule:

Any sick newborn → check glucose early.
Any symptomatic hypoglycaemic newborn → treat immediately.

Hypoglycaemia is especially common in:

• infants of diabetic mothers
• preterm infants
• small for gestational age infants
• large for gestational age infants
• sick/asphyxiated/septic n