Newborn Hypoglycemia and Breastfeeding

What is Hypoglycemia?

“Hypoglycemia" is another name for “low blood sugar". Glucose is the body’s main fuel source. Your liver takes the carbohydrates you eat and turns it into glucose; the glucose is then sent into your blood stream 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 hypoglycaemia in a baby. While one doctor may say that  a baby has hypoglycaemia, another may say something different. Some babies may show low blood sugar levels, but may have absolutely no symptoms. 

Severe newborn Hypoglycaemia 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 Hypoglycaemia 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".

What are the Newborn Hypoglycemia Symptoms?

  • A high pitched cry.
  • Weakness and fatigue.
  • Signs of hypoglycemia may include Irritability and fussiness.
  • Signs and symptoms of hypoglycaemia may include restlessness. 
  • Fast and irregular breathing. 
  • Hypothermia. (temperature drop)
  • Apnea. (shallow breathing) 
  • The baby may seem pale in colour.
  • 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 other twin).
  • The baby losing warmth. (Extra energy is needed to regulate temperature). This is why skin to skin contact is so important. 
  • Hypoxia (lack of Oxygen) can increase the risk of newborn Hypoglycemia. 
  • Any respiratory distress can cause low blood sugar in babies.
  • Any perinatal stress. 
  • Polycythermia. (blood cell problem).
  • Erythroblastosis fetalis (Immune response).
  • Any infection that puts extra stress on the body.
  • Any central nervous system problems.

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

  • Diabetes is a very high risk factor.
  • A 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 important that the baby breastfeeds enough, if the baby is not, it can make hypoglycaemia 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. Read more about breastfeeding with diabetes here. 
  • 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.
Top of newborn Hypoglycemia page

Other pages on breastfeeding problems in connection with newborn hypoglycemia.

Tracy Behr, CBC, CLD (CBI)

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

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