For at-risk newborns — infants of diabetic mothers, small or large for gestational age, late preterm — the backbone of preventing transitional hypoglycaemia remains early skin-to-skin contact and a first feed within the first hour, then glucose checks before the second and subsequent feeds. Transitional glucose falls in the first hours are physiological. Treat symptomatic babies promptly, follow your unit's thresholds for asymptomatic low values, and use dextrose gel as treatment where it is part of that protocol, not as routine prophylaxis.
- Start skin-to-skin contact and a first feed within an hour of birth for at-risk babies.
- Check blood glucose before the second feed, not immediately after birth.
- Treat symptomatic hypoglycaemia immediately with intravenous dextrose.
- Use dextrose gel for treatment within a protocol, not routine prophylaxis.
Why it matters
Good early feeding does more for most at-risk babies than any preventive drug.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for paediatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free