Hypoglycemıa Of Infancy and Chıldhood and Nutrıtıonal Management

Abstract

Hypoglycemia in the fullsize newborn is defined as concentration of glucose in blood less than 30 mg/dL between birth and 72 hours of age or concentration less than 40 mg/dL thereafter. In the infant of low birth weight, hypoglycemia is defined as concentration of glucose in the blood less than 20 mg/dL. The two major causes of the hypoglycemia of the newborn are deficient hepatic glucose production and hyperinsulinism. Among low birth weight infants hypoglycemia develop because of deficient hepatic glyconeogenesis from lipids and amino acids from lack of delivery of substrate. Clinical findings associated with hyoglycemia are tremors, cynanosis, convulsions, aplnea, apathy, weak cry, refusal to feed and irregular respiration. Oral feedings are instituted as soon as clinical manifastations subside but the l.V. infusion is continued for 48 hours after concentration of glucose returns to normal 1.5 g/100 mL solution of glucose or a milk based formula is to be preferred at least after 48 hours of age. A milk based formula seems preferable because of its provision of various nutrients other than carbohydrates. Frequent small feedings at greater intervals are probably preferable to larger feedings at greater intervals. But the resudial stomach content must be monitored closely. Enteral feeding at intervals or 1 to 2 hours generally be found to be practical