Hypoglycemia in the Newborn

Hypoglycemia means low blood sugar. It's a condition in which the amount of blood glucose (sugar) in the blood is lower than normal.

Approximately two out of 1,000 newborn babies have low blood sugar.  During pregnancy, glucose is passed to the baby from the mother through the placenta.  Some of the glucose is stored as glycogen in the placenta, and later in the baby's liver, heart and muscles.  These stores of sugar are important for supplying the baby's brain with energy during delivery and for nutrition after the baby is born. 

Babies who are more likely to develop hypoglycemia include:

  • Babies born to diabetic mothers
  • Small for gestational age or growth-restricted babies 
  • Premature babies, especially those with low birth weights

Hypoglycemia may be caused by conditions that:

  • Lower the normal supply of glucose in the bloodstream
  • Prevent or decrease the storage of glucose
  • Rapidly use up glycogen stores (sugar stored in the liver)
  • Prevent the body from using glucose 

Many different conditions are associated with hypoglycemia in the newborn, including:

  • Poor nutrition of the mother during pregnancy
  • Severe hemolytic disease of the newborn (blood types of the mother and baby are not compatible)
  • Birth defects, endocrine disorders and metabolic diseases present at birth
  • Poor intake of oxygen during birth (birth asphyxia)
  • Exposure to the cold (cold stress)
  • Liver disease

The brain depends on blood glucose as its main source of energy. The brain will not function normally if there is not enough glucose. Severe or long-drawn-out low blood sugar may result in seizures and serious brain injury.

Glucose is an important source of immediate energy for the body. It is the main source of energy for the brain in babies and young children. It is found in many foods, and between meals the body is able to control the level of glucose using supplies of glucose stored as glycogen in the liver or muscle. Glucose not used by the body is changed to fat.

Symptoms of hypoglycemia may not be obvious in newborns. Each baby may experience symptoms differently. The most common symptoms include:

  • Restlessness
  • Blue skin coloring (cyanosis)
  • Stopping breathing (apnea)
  • Low body temperature (hypothermia)
  • Poor body tone
  • Poor feeding
  • Sluggishness (lethargy)
  • Seizures

The symptoms of hypoglycemia may look like other conditions or medical problems. Always consult your baby's physician if you notice these changes in your child.

A simple blood test for blood glucose levels can diagnose hypoglycemia. Blood may be drawn from a heel stick, from the baby's arm, or through an umbilical catheter (a tube placed in the baby's umbilical cord). Generally, a baby with low blood glucose levels will need treatment.

Specific treatment for hypoglycemia will be determined by your baby's physician based on:

  • Your baby's gestational age, overall health, and medical history
  • Extent of the disease
  • Your baby's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Treatment includes giving the baby a rapid-acting source of glucose. This may be as simple as giving a glucose / water mixture or formula as an early feeding. Or, the baby may need glucose given intravenously (IV). The baby's blood glucose levels are closely monitored after treatment to see if the hypoglycemia occurs again. Remember that you must not give a baby sugar water or anything by mouth if they are experiencing a seizure or are unresponsive in any way.  Call 911 if this happens. 

Unfortunately, we do not know of any way to prevent hypoglycemia in the newborn. We recommend watching carefully for the symptoms and treat as soon as possible. Mothers with diabetes who have blood glucose levels in good control can decrease the amount of glucose that goes to the baby during pregnancy.  


Last Updated 12/2012