Neobook — clinical reference

Prevent Low Blood Sugar

Treat Low Blood Sugar

Prevent Low Blood Sugar in Young Infants (Hypoglycaemia)

If the young infant is able to swallow:

If breastfed: ask the mother to breastfeed the child
If the baby is too sick to feed, give 3ml/kg per hour of expressed breastmilk on the way to hospital
If baby has severe lethargy and cannot swallow, give the milk by nasogastric tube

If feeding is contraindicated:

Put up intravenous (IV) line and give 10% Neonatalyte by slow IV infusion at 3ml/ kg/hour (3 drops per kg/hour)
Use a dial-a flow to monitor the flow rate
Example: If the baby weighs 4 kg then give 12 ml/hour

Treat for Low Blood Sugar (Hypoglycaemia)

Suspect low blood sugar in any infant or child that:
- is convulsing, unconscious or lethargic
  OR
- has a temperature below 35ºC
Confirm low blood sugar using blood glucose testing strips
Keep the baby warm at all times

Low blood sugar (< 2.5 mmol/L) in a young infant

Breastfeed or feed expressed breastmilk
If breastfeeding is not possible give 10mg/kg of replacement milk feed
Repeat the blood glucose in 15 minutes while awaiting transport to hospital
If the blood sugar remains low, treat for severe hypoglycaemia (see below)
If the blood glucose is normal, give milk feeds and check the blood glucose 2-3 hourly

Low blood sugar < 1.4 mmol/L in a young infant

Give a bolus of 10% dextrose infusion (Neonatalyte) at 2ml/kg
Then continue with the 10% dextrose infusion at 3ml/kg/hour
Repeat the blood glucose in 15 minutes.
If still low repeat the bolus of 2ml/kg and continue IV infusion
Refer URGENTLY and continue feeds during transfer
If neonatalyte not available add 1 part 50% dextrose water to 4 parts water to make 10% solution

Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Treat the Young Infant: Prevent Low Blood Sugar, Treat Low Blood Sugar

Last checked for updates: June 2023