Hypoglycemia in breastfed neonates: a hospital-based study

Abstract

Background: Neonates has well-coordinated adaptation system which maintains the blood sugar at certain safe level in extra uterine life. However certain intrauterine risk factors alter this adaptation system leading to hypoglycemia in early post-natal period. Most of the time hypoglycemic episodes are transient but sometimes there may be recurrent or prolonged hypoglycemia leading to permanent insult in brain and neurological deficit in post-natal life. Aims and objective of the study was to find out incidence of hypoglycemia in exclusively breastfeed neonates and the risk factors associated with this in the post-natal ward of a tertiary care centre in North-East India. Methods: This is a prospective study conducted for a period of six month, where 112 exclusively breastfeed neonates who were shifted immediately to post-natal ward were included. Capillary blood sugar was checked at 1, 3, 6, 12, 24, 48 and 72 hours of life. Neonates with capillary blood glucose less than 40 were considered hypoglycemic. All the hypoglycemic babies were extensively evaluated for different intrauterine and post-natal risk factors. Results: Incidence of hypoglycemia was 16% (18 out of 112 babies). Significant numbers (30.5%) of LBW babies had hypoglycemia, where as 6.5% of normal birth weight babies had hypoglycemia. 38.8% of preterm babies had hypoglycemia where as 11.95% of term babies had hypoglycemic episodes. 71.4% (5 out of 7 babies) of neonates born from diabetic mother. All the large for date infants of diabetic mother had hypoglycemia. Conclusions: Our study came to a conclusion that incidence of hypoglycemia is not very uncommon finding in exclusively breastfeed neonates especially those with risk factors. Routine capillary blood glucose screening is utmost important to pick up the babies with hypoglycemia to prevent immediate and long-term complication.