Neonatal hypoglycaemia is the commonest early complication in babies of mothers with pre-existing or gestational diabetes, including diabetes diagnosed late in the third trimester. Fetal hyperinsulinaemia persists after the cord is cut while the glucose supply stops.
NICE advises feeding as soon as possible after birth, within about 30 minutes, then every two to three hours, and checking the baby's blood glucose two to four hours after birth. A late diagnosis should trigger the same plan as an early one.
- Flag a late diagnosis of gestational diabetes on the labour record so the neonatal team plans glucose monitoring.
- Encourage feeding within about 30 minutes of birth and then every two to three hours.
- Check blood glucose two to four hours after birth, before the hypoglycaemia window passes unnoticed.
- Keep mother and baby together unless a clinical complication requires admission.
Why it matters
A diagnosis made weeks before birth is the one most likely to be missed on the neonatal plan.
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