Midwifery/Nursing management of hypoglycaemia in healthy full term neonates

Abstract

Objectives The objectives of this review are to determine from the available evidence: • the maintenance of euglycaemia in healthy full term neonates, and • the management of asymptomatic hypoglycaemia in otherwise healthy full term neonates. Questions The specific questions being asked are: Does the available evidence support the types and timing of various midwifery/nursing interventions that are commonly used to: • prevent hypoglycaemia in healthy full term neonates? • manage asymptomatic hypoglycaemia in otherwise healthy full term neonates? Criteria for considering studies for this review Types of participants Studies that include healthy full term (37-42 weeks gestation) neonates in the first 72 hours following birth. Exclusions: • Preterm or SGA newborns • Full term neonates with a diagnosed medical or surgical condition, congenital or otherwise. • Babies of diabetic mothers. • Neonates with symptomatic hypoglycaemia. • LGA neonates (as significant proportion are of diabetic mothers) Types of interventions All interventions that fall within the scope of practice of a midwife/nurse will be included. The interventions of primary interest are those related to: • Type (breast or breast milk substitutes), amount and/or timing e.g. initiation of feeding, and frequency • Maintenance of body temperature • Monitoring (including screening) of both ‘not-at-risk’ and ‘at risk’ neonates, including blood or plasma glucose levels (bgl/pgl) and other forms of monitoring Types of outcome measures Outcomes that are of interest include, but are not confined to: • Successful breastfeeding • Occurrence of hypoglycaemia • Re-establishment and maintenance of bgl/pgl at or above set threshold (as defined in a particular study) • Developmental outcomes