Symptoms:

Infants with hypoglycemia may not have symptoms. If they do occur, symptoms may include:

• Bluish-colored skin (cyanosis)
• Breathing problems
• Decreased muscle tone (hypotonia)
• Grunting
• Irritability
• Listlessness
• Nausea, vomiting
• Pale skin
• Pauses in breathing (apnea)
• Poor feeding
• Rapid breathing
• Problems with maintaining body heat
• Shakiness
• Sweating
• Tremors
• Seizures

Signs and tests:

Newborns at risk for hypoglycemia should have a blood test to measure blood sugar levels every few hours after birth. The health care provider should continue taking blood tests until the baby' s blood sugar level is consistently normal.

Other possible tests:

• Newborn screening for metabolic disorders
• Urine tests

Treatment:

Infants with hypoglycemia may need to receive:

• Feeding with breast milk or formula within the first few hours after birth, either by mouth or through a tube inserted through the nose into the stomach (nasogastric lavage)
• A sugar solution through a vein (intravenously) if the baby is unable to feed by mouth, or if the blood sugar is very low

Treatment normally continues for a few hours or days to a week.

If the low blood sugar continues, the baby may also receive medication to increase blood glucose levels (diazoxide) or to reduce insulin production (ocreotide).

In rare cases, newborns with very severe hypoglycemia who don' t improve with treatment may need surgery to remove part of the pancreas (to reduce insulin production).

Expectations (prognosis):

The outlook is good for newborns who do not have symptoms, or who have hypoglycemia that gets better with treatment. However, hypoglycemia can return in a small percentage of babies after treatment.

The condition is more likely to return when babies are taken off intravenous feedings before they are fully ready to eat by mouth.

Babies with symptoms are more likely to develop problems with learning. This is especially true for babies with lower-than-average weight or whose mothers have diabetes.

Complications:

Severe or long-term hypoglycemia may lead to brain damage, affecting normal mental function. Complications may include:

• Developmental delay
• Heart failure
• Seizures

Calling your health care provider:

Call your health care provider if your baby has symptoms of neonatal hypoglycemia.

Prevention:

If you have diabetes during pregnancy, work with your health care provider to control your blood sugar levels. Be sure that your newborn's blood sugar levels are monitored after birth.