Newborn Hypoglycemia and Breastfeeding


What is Hypoglycemia?

“Hypoglycemia" is another name for “low blood sugar." Glucose is the body’s primary fuel source. Your liver takes the carbohydrates you eat and turns it into glucose; the glucose is then sent into your bloodstream and provides energy to the body. When the body’s blood glucose is low, it is called hypoglycemia. 

While a baby is in utero, he/she is continuously receiving glucose through the placenta. The baby will store some of this glucose as glycogen in the liver for after birth. This glycogen usually only lasts about 12 hours, in which time the baby will start producing his/her own glucose from the milk consumed. There is always a normal drop in blood sugar levels 1-2 hours after birth, this is as a result of the baby adapting outside the womb. 

It is important to get a second opinion on the diagnosis of hypoglycemia in a baby. While one doctor may say that a baby has hypoglycemia, another may say something different. Some babies may show low blood sugar levels but may have absolutely no symptoms. 

Severe newborn Hypoglycemia can deny the brain from fuel and cause seizures and even brain damage. 


Should a Hypoglycaemic Baby Breastfeed? 

Yes, in fact, it is really beneficial for a baby with Hypoglycemia to breastfeed. Why? 

  • Breastfed babies produce more Ketones than formula fed babies. These ketones can be used as brain fuel.
  • Breastfed babies can, therefore, tolerate lower levels of glucose without developing clinical symptoms. 

Interesting fact ~ Breastfed babies usually have a lower blood sugar level than their formula-fed counterparts. This is not an indication of a problem, but caregivers often take the physiology of artificially fed babies as “normal."


Hypoglycemia Symptoms in Newborn Babies.

newborn, umbilical cord
  • A high pitched cry.
  • Weakness and fatigue.
  • Signs of hypoglycemia may include Irritability and fussiness.
  • Signs and symptoms of hypoglycemia may include restlessness. 
  • Fast and irregular breathing. 
  • Hypothermia. (temperature drop)
  • Apnea. (shallow breathing) 
  • The baby may seem pale in color.
  • There may be dampness of the skin. 
  • weak suck.
  • Breast refusal. 


Newborn Hypoglycemia Risk Factors 

  • Low birth weight. (Less than 2,5kg).
  • Too large or too small for gestational age.
  • Post-term birth (over 42 weeks).
  • A smaller twin (weighing more than 10% less than the other twin).
  • The baby may be losing warmth. (Extra energy is needed to regulate temperature). This is why skin to skin contact is so vital. 
  • Hypoxia (lack of Oxygen) can increase the risk of newborn Hypoglycemia. 
  • Any respiratory distress can cause low blood sugar in babies.
  • Any perinatal stress. 
  • Polycythemia. (blood cell problem).
  • Erythroblastosis fetalis (Immune response).
  • Any infection that may put extra stress on the body increases the risk factor.
  • Any central nervous system problems.


Hypoglycemia Risk Factors in the Mother that Increase the Baby's Risk

  • Diabetes is a very high-risk factor.
  • Long labor may be one of the causes of hypoglycemia.
  • A Glucose IV used during labor. 
  • Toxemia. 
  • Pregnancy-induced hypertension.
  • The use of Terbutaline, Propranolol, and oral Hypoglycemics.


The Impact on Breastfeeding

  • The baby may be very fussy at the breast. How to handle a fussy baby while breastfeeding. 
  • The baby may be sleepy most of the time. How to handle a sleepy baby while breastfeeding. 
  • It is essential that the baby breastfeeds enough, if the baby is not, it can make hypoglycemia symptoms worse. 
  • Supplements can interfere with breastfeeding. 


Making Breastfeeding Easier

  • The mother and her baby should not be separated at birth.
  • Skin-to-skin contact increases blood glucose levels.
  • Breastfeed as early and as often as possible. 
  • Testing of babies that are asymptomatic is unnecessary and can cause more problems. 
  • Avoid supplementation. Milk fortifiers may be used in low birth weight infants. Breast milk is always the safest and most nutritionally suitable food. When is supplementation necessary? 
  • The baby should be kept warm. 


Can you Prevent Hypoglycemia in a Baby?

  • Diabetic, hypoglycemic mothers should control their diabetes well during pregnancy. 
  • A healthy diet and exercise in ladies with diabetes (during pregnancy) can prevent further problems that may make the risk even higher. 
  • Avoid using glucose IVs during birth. Women should be allowed to eat and drink instead.
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Tracy Behr, CBC, CLD (CBI)

Reference: Breastfeeding counselor course through childbirth international on the physiology of breastfeeding/health problems/Newborn hypoglycemia.

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