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Neonatal hypoglycaemia — RACP Paediatrics MCQ

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ModerateNeonatologyNeonatal hypoglycaemiaRACP Paediatrics

A 4-hour-old term infant of a mother with gestational diabetes becomes jittery and tachypnoeic. Bedside glucose is 1.7 mmol/L, confirmed on repeat testing; the baby is not able to suck effectively. What is the most appropriate management?

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

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Correct answer: D — Start intravenous glucose and monitor blood glucose closely

Symptomatic neonatal hypoglycaemia, especially with ineffective feeding, requires prompt intravenous glucose and close monitoring. Buccal dextrose gel is useful in selected well babies who can feed, but this infant has symptoms and poor feeding. The clinical pearl is that infants of diabetic mothers are at risk from hyperinsulinism soon after birth.

Reference: RCH Clinical Practice Guidelines: Neonatal hypoglycaemia; AMH Children's Dosing Companion