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Neonatal hypoglycaemia — RACP Paediatrics MCQ

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EasyNeonatologyNeonatal hypoglycaemiaRACP Paediatrics

A term infant of a mother with gestational diabetes is jittery at 90 minutes of age. He is warm, pink and feeding poorly. Bedside glucose is 1.8 mmol/L and does not improve after an effective breastfeed. What is the most appropriate management?

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Correct answer: B — Administer buccal dextrose gel and arrange urgent reassessment

Symptomatic or persistent neonatal hypoglycaemia requires prompt treatment, and buccal dextrose gel with feeding is appropriate while reassessing the response. Observation is unsafe because the baby is symptomatic and the glucose is low. A laboratory sample may be useful, but treatment should not be delayed when the bedside result fits the clinical picture.

Reference: RCH Neonatal hypoglycaemia guideline; AMH Children's Dosing Companion