Treatment and Prevention

Why does hypoglycemia occur in newborns and how is it treated?

Hypoglycemia in newborns is a phenomenon in which the level of glucose in their blood 2-3 hours after birth falls below 2 mmol / l. Statistics show that this condition develops in 3% of all children. Inadequate development, low weight, perinatal asphyxia can provoke hypoglycemia in children.

To the doctor put such a diagnosis, he conducts a newborn glucose test. Such a condition is eliminated simply - the treatment consists in the intravenous administration of glucose. It is hypoglycemia that is one of the most common causes of death among newborns.

Classification

Hypoglycemia in newborns is of two types: permanent and transient. The transitory type arises against the immaturity of the pancreas, which cannot produce enough enzymes, or a low substrate reserve. All this does not allow the body to accumulate the necessary amount of glycogen. In rare instances, persistent hypoglycemia is diagnosed in newborns. This type of lesion is characterized by dependence on insulin, it occurs because of a violation of the production of contra-insular hormones. In rare cases, such a lesion is caused by a metabolic disorder.

Prematurity in children with insufficient body weight or with placental insufficiency can provoke the development of transient hypoglycemia. Intra-natal asphyxia may also lead to this consequence. The lack of oxygen destroys the body's glycogen stores, so hypoglycemia can develop in these children within a few days of life. A long interval between feedings can also lead to this consequence.

It is very important to ensure a steady flow of glucose into the body to prevent the development of hypoglycemia.

Transient hypoglycemia most often occurs in newborns whose mother suffers from diabetes. This phenomenon also develops on the background of physiological stress. In rare cases, this pathology is caused by an autoimmune disease, in which the body requires a large amount of insulin. Hyperplasia of cells in the pancreas, Beckwith-Wiedemann syndrome can provoke the development of a similar pathology.

The reasons

Hypoglycemia in newborns can develop immediately after birth and up to 5 days of its development. In the overwhelming majority of cases, such a violation is attributed to insufficient intrauterine development or a delay in the formation of internal organs.

Also metabolic disturbance can lead to hypoglycemia. The greatest danger is the persistent form of such a deviation. She says that hypoglycemia is caused by congenital abnormalities. This condition requires constant monitoring and constant drug maintenance.

In transient hypoglycemia, a decrease in the sugar concentration decreases one-time, after a rapid cupping the seizure does not require any long-term treatment. However, two types of single abnormalities require a quick response from the doctor. Even a slight delay can cause serious deviations in the work of the nervous system, which in the future can lead to deviations in the work of the internal organs.

Among the most common causes of hypoglycemia in newborns are:

  • Therapy for pregnant women with long-acting insulin;
  • Diabetes in the mother;
  • The use of large amounts of glucose by the mother shortly before delivery;
  • Fetal hypotrophy inside the womb;
  • Mechanical asphyxia during labor;
  • Insufficient adaptation of the child;
  • The consequences of infectious processes.

Most often, hypoglycemia in newborns is caused by prematurity, immaturity at the time of gestation, or subsequently hypoxia.
Their bodies cannot accumulate a sufficient amount of glucose, which is why the first signs of hypoglycemia can be noticed in their first hours of life.

First signs

Hypoglycemia in newborns develops quite quickly. It arises due to the defeat of the pancreas, which can not produce enough insulin and other enzymes. Because of this, the body can not store the proper amount of glycogen.

Recognize hypoglycemia in newborns by the following symptoms:

  • Blue skin of the lips;
  • Pallor;
  • Muscle cramps;
  • Weakened condition;
  • Apathy;
  • Sudden bouts of screaming;
  • Tachycardia;
  • Increased sweating;
  • Worry.

Diagnostics

To diagnose hypoglycemia in newborns is quite simple. To do this, it is enough for the doctor to perform advanced blood tests. They help the specialist to identify the first manifestations of acute or prolonged hypoglycemia in children. Usually, the following tests are performed to confirm the diagnosis:

  • Complete blood count for glucose;
  • Complete blood count to determine the level of fatty acids;
  • Complete blood count to determine the level of ketone bodies;
  • Complete blood count to determine the concentration of insulin in the blood;
  • Hormonal blood test for cortisol, responsible for the growth and development of the body.

Treatment

It is very important that the treatment of hypoglycemia in newborns be immediate. To determine this condition in a child, the doctor uses instant test strips that quickly determine the concentration of glucose in the blood. If the indicator does not reach the level of 2 mmol / l, then the child takes blood for an extended study. After confirming the diagnosis, a specialist injects a certain amount of glucose intravenously.

Most often, hypoglycemia in children occurs in the first 10 hours of life.

It develops due to late nutrition. After stopping the attack, the symptoms of hypoglycemia can disappear without a trace and consequences for the body.

It is very important to adhere to the following rules in the treatment of such a condition:

  • You can not abruptly interrupt the introduction of glucose - this can lead to aggravation of hypoglycemia. Termination is slow, the doctor gradually reduces the dose of the active substance.
  • The introduction of glucose should start with 6-8 mg / kg, gradually increasing to 80.
  • It is strictly forbidden to inject glucose more than 12.5% ​​into the peripheral veins of a child.
  • It is not recommended to interrupt feeding during the introduction of glucose.
  • If glucose is administered to a pregnant woman to prevent hypoglycemia in her newborn baby, care must be taken to ensure that the concentration of sugar in the blood does not rise above 11 mmol / l. otherwise, it may lead to hypoglycemic coma in a pregnant woman.

With the right approach to therapy, the doctor will be able to quickly stop an attack of hypoglycemia in a child.

Also, if a pregnant woman complies with all recommendations of the attending physician, she will also be able to reduce the risk of developing not only a decrease in sugar concentration in the newborn, but also prevent the occurrence of hyperbilirubinemia, erythrocytosis and various respiratory disorders.

Effects

Hypoglycemia - a serious deviation in the functioning of the body, which can lead to serious consequences. To assess their severity, numerous studies have been conducted. They allow us to understand how the organs and systems of the child will develop due to hypoglycemia. Numerous studies have shown that due to the decline in glucose levels in newborns, serious disturbances in the functioning of the brain develop. This leads to the development of diseases of the nervous system, increases the risk of acquiring epilepsy, the growth of tumors.

Also transferred hypoglycemia is reflected in the level of the child's intelligence and his motor abilities.
The possibility of acquiring cerebral palsy and bouts of hypoglycemia in the future is significantly increased. These children are on special account in clinics, require more attention from the attending physician.

Prevention

Prevention of hypoglycemia in newborns is in a timely and nutritious diet. If you start to lure only 2-3 days after birth, the risk of developing such a condition will be extremely high. After the baby is released, the child is connected to the catheter, through which, after 6 hours, the first nutrient mixture is injected. On the first day, he is also given about 200 ml of breast milk.

If the mother does not have milk, then special intravenous drugs are administered to the child, the dose of which is about 100 ml / kg. If there is an increased risk of hypoglycemia, the child’s blood sugar concentration is checked every few hours.

Watch the video: Treating Low Blood Sugar. Hypoglycemia. Nucleus Health (September 2019).