INCIDENCE OF HYPOGLYCEMIA IN EXCLUSIVELY BREASTFED HIGH-RISK NEWBORNS

Abstract

Background: Hypoglycemia is one of the commonest metabolic complications seen during neonatal period. In healthy newborns low blood glucose may not have much signicance and merely reect normal metabolic adaptation to extra-uterine life. However, in high-risk newborns, prolonged and/or recurrent episodes of hypoglycemia may negatively affect neurological and developmental prognosis. The incidence of hypoglycemia varies worldwide depending upon the blood sugar measurement protocols and feeding policies. There is paucity of data on incidence of hypoglycemia in institutions where exclusive breastfeeding is followed. Aims and Objectives: To determine the incidence and associated risk factors of hypoglycemia in rst 72 hours of life among exclusively breastfed healthy high-risk newborns.Study Design: Observational study Setting: Department of Pediatrics, Nalanda Medical College and Hospital Patna, Bihar, India. Period: From 1st July 2019 to 31st December 2019. Material & Methods: The Observational study enrolled 560 exclusively breastfed high-risk newborns (infant of diabetic mother (IGDM/IDM), large-for-gestation (birth weight >90th percentile), small-for-gestation (birth weight <10th percentile), low birth weight (>1800 to <2500 grams) and late preterm), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Babies on formula or pre-lacteal feed, major congenital malformations and admitted in NICU for other reasons were excluded from the study. Hypoglycemia screening was done at 2, 6, 12, 24, 48 and 72 hours of life, prior to feeding. Hypoglycemia was dened as blood glucose ≤40 mg/dL(2.2 mmol/L). Blood glucose was estimated from heel prick capillary samples using glucometer. Association of both maternal and neonatal risk factors was studied in relation to hypoglycemia. Result: Incidence of hypoglycemia in high-risk newborns was 27.1%. Incidence was signicantly higher in pre-term, low birth weight, Small-for-gestation age babies delivered to mothers with BMI >30 kg/m2, born through caesarean section. Conclusion: in high-risk exclusively breast fed neonates blood glucose level should be regularly monitored for at least 1st 72 hours of life with special attention to 1st 24 hours.