1. HYPOGLYCEMIA/ HYPERGLYCEMIA
IN THE NEONATE
What is the definition of a neonate?
The first 30 days of an infants life or
A premature infant that has not been discharged since being born

2. Hypoglycemia:
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What is it?

3. Blood sugar 4. Depends on reference 5. Bedside testing 6. Fairly accurate 7. F/U with serum glucose 8. Higher than bedside test 9. Not accurate if not run quicklyClick on speaker to hear more information on each slide.
10. HYPOGLYCEMIA
Who is at risk? And why?

Infant of diabetic mother

11. Hyperinsulinemia 12. Premature infant 13. Decreased glycogen stores 14. SGA/LGA infant 15. Hyperinsulinemia 16. Stressed or Sick infant 17. Using their glucose quicklySigns & Symptoms:
Jitteriness, Irritability, Hypotonia, Lethargy, Hypothermia, Respiratory distress, Seizures.. Or there may be NONE.
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18. Management of Low Blood Sugar
For the term baby in no sign of distress:
Early feeding usually with formula or breastfeeding
Follow-up blood sugar 30 min to 1 hour after feeding
Continue to monitor blood sugar according to hospital policy
For a term baby in distress:
Management will be with IV fluids or gavage feeding depending on symptoms
For a preterm baby:
IVF D10W (initial fluids)
IV Bolus of 2 ml/kg of D10W
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19. Hyperglycemia:
Blood sugar < 200 mg/dl
Causes:

Stress

20. Will usually resolve with time 21. Prematurity 22. May need lower sugar concentration in IVF 23. May need insulinClick on speaker to hear more information on each slide.
24. Things to remember:
HYPOGLYCEMIA:

Blood sugar < 45 mg/dl

25. At risk: IDM, SGA, LGA, Prematurity, Stress 26. TX: early feedings, IVF, monitor closelyHYPERGLYCEMIA:
Blood sugar > 200 mg/dl

Causes: stress, severe prematurity

27. TX: usually self resolves; except in severe preemieDIABETES in the NEONATE is RARE
here.
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EDUCATION/ PREVENTION:

Identify at risk patients type I, type II, and gestational diabetic moms

28. Educate mom about potential risks to fetus/ newborn 29. Educate mom on importance of maintaining good glucose control during pregnancy 30. Early recognition of at risk infants 31. Early feedings for at risk infants 32. Ongoing communication with the family regarding infants statusClick on speaker to hear more information on each slide.
33. PAIN MANAGEMENT:
Sucrose Pacifier
One last important note: PAIN MANAGEMENT

Heel stick = HURTS

34. IV insertion = HURTS 35. Babies feel pain! 36. Babies remember pain! 37. Baby a patient advocate and provide appropriate pain management!Swaddling, decreased light, sucrose pacifier, holding to name a few.
Dim the lights
Swaddle the baby
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