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Neonatal hypoglycaemia — MCCQE Part 1 MCQ

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EasyNeonatal DistressNeonatal hypoglycaemiaMCCQE Part 1

2-hour-old infant of a diabetic mother presents with jitteriness. Point-of-care glucose is 1.9 mmol/L. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Feed or give dextrose according to severity and recheck glucose promptly

Feed or give dextrose according to severity and recheck glucose promptly is best because infants of diabetic mothers are at risk and symptomatic hypoglycaemia needs immediate treatment. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Persistent or symptomatic neonatal hypoglycaemia risks brain injury.

Reference: Canadian Paediatric Society neonatal hypoglycaemia statement