Since the brain depends on blood glucose as its core source of fuel, too little risks impairing brain functioning. Prolonged hypoglycemia can lead to serious brain injury and seizures.

Hypoglycemia Symptoms

Symptoms in newborns often include:

To diagnose hypoglycemia in newborns, a simple blood test that tests the baby’s glucose levels can be done.

Treatment typically includes giving the newborn a rapid-acting source of glucose, such as glucose and water mix. Some babies may require intravenous glucose administration.

Electrolytes and Hypothermia

Mild hypothermia, such as cooling therapy, can shift potassium in the cells and predispose infants to hypocalcemia, and other conditions. During the re-warming phase, rebound tends to increase the electrolytes. However, hyperkalemia may be prevented by slowing and controlling the re-warming period and allowing the kidneys to excrete excess potassium.

Cooling Therapy and Nutrition Support

Mild hypothermia tends to create a shift of electrolytes, leading to the potential for:

During the rewarming phase, there is a potential for increased serum levels of the electrolytes, particularly after replacement of electrolytes during the cooling therapy. Providing nutrition during the treatment, especially for infants, can add refeeding associated with the electrolyte shifts caused by cooling.

Furthermore, therapeutic cooling can decrease insulin sensitivity, which may necessitate increased doses of insulin during treatment. The insulin sensitivity tends to be increased during the warming period, though, which can lead to the risk of hypoglycemia and the potential for an increase in glucose variability. Providing nutrition can increase insulin requirements and increased the possibility of hypoglycemic events or even glucose variability, particularly during re-warming as the infant’s insulin sensitivity improves.

Issues related to glucose control as well as electrolyte management during the nutrition support are dealt with daily in infants undergoing cooling therapy. But, given the lack of data during cooling therapy, it is important for medical staff to be vigilant in case alternate protocols and tighter monitoring is needed both during cooling and re-warming.

Infants who have low blood sugar levels will require extra feedings with formula or breast milk, which can be given during cooling therapy. What’s more, the baby may need a sugar solution given intravenously if he or she cannot feed by mouth or if his or her glucose level is significantly low.

Treatment is usually continued for a few hours up to a week, or until the baby’s glucose levels stabilize on re-warming. Premature babies and those born with a low weight or infection must be treated for longer.

Should low blood sugar and electrolyte levels continue, the baby can be given medication to increase his or her levels. In rare circumstances, newborn babies with severe hypoglycemia who do not improve with appropriate treatment may require surgery in order to remove part of the pancreas which will help reduce insulin production.