Hypoglycemia in Newborns: What Parents Should Know

Neonatal hypoglycemia—low blood sugar in newborns—is a common condition that often appears shortly after birth. In most cases, it resolves on its own once the baby starts feeding regularly. Doctors typically detect low blood sugar while monitoring the newborn after delivery. If glucose levels remain unstable, the baby may not be discharged from the hospital until levels stabilize.

However, if hypoglycemia persists beyond the first 48 hours after birth, it may indicate an underlying medical condition that requires immediate attention. Early detection and treatment are crucial to prevent long-term complications.

Normal Blood Sugar Levels in Newborns

Blood glucose levels can vary depending on the baby’s condition. A newborn is generally considered to have hypoglycemia if blood glucose falls below 30 mg/dL after the first 24 hours of life.

Signs of Low Blood Sugar in Newborns

Not all newborns show obvious symptoms, especially in the early stages. Therefore, many hospitals routinely screen at-risk infants and repeat the tests as needed. Common signs include:

• Blue-tinged lips or skin (cyanosis)

• Poor interest in breastfeeding

• Weak or floppy muscles

• Low energy or lethargy

• Low body temperature

• Seizures in severe cases

Persistent hypoglycemia for three days or longer may indicate a more serious problem.

Causes of Neonatal Hypoglycemia

1. Maternal Diabetes
   Mothers with uncontrolled diabetes have higher blood glucose levels, which cross the placenta and stimulate insulin production in the fetus. After birth, when the maternal glucose supply is removed, the newborn may experience low blood sugar due to continued high insulin levels.

2. Poor Maternal Nutrition
   Inadequate maternal nutrition can lead to low birth weight or reduced glycogen stores in the baby, increasing the risk of hypoglycemia and higher metabolic demands.

3. Premature or Post-term Birth
   Glycogen stores develop mainly in the third trimester. Premature infants may have lower glycogen reserves, which deplete quickly, making them more susceptible to low blood sugar.

4. High Red Blood Cell Count (Polycythemia)
   Excess red blood cells can slow blood flow and increase the risk of hypoglycemia and low calcium levels.

Other maternal conditions, such as postpartum hypertension, can also increase the baby's metabolic needs.

Diagnosis and Treatment

Diagnosis:

• Blood glucose testing is used to measure the newborn’s blood sugar.

• Additional tests may be required to rule out metabolic disorders or other underlying causes.

Treatment:

• Mild cases may be managed by frequent breastfeeding.

• In severe cases, infants may receive intravenous glucose if they cannot feed or their blood sugar is critically low.

• Duration of treatment can range from several hours to several days, depending on the severity.

High-risk infants, such as preterm babies, those with infections, or low birth weight, may require longer monitoring and intensive care.

Key Takeaways:

• Early detection and intervention are essential to prevent complications.

• Persistent or recurrent hypoglycemia beyond 48 hours warrants immediate medical evaluation.

• Proper maternal care during pregnancy—including managing diabetes and maintaining good nutrition—reduces the risk of neonatal hypoglycemia.