Early feeding and neonatal hypoglycemia in infants of diabetic mothers

Abstract

Objectives:To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics.Methods:Infants with hypoglycemia (blood glucose < 40 mg/dL) were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose.Results:Of 293 infants admitted to the well-baby nursery, 87 (30%) had hypoglycemia, corrected by early feeding in 75 (86%), while 12 (14%) required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%), prematurity (33%) or prevention of hypoglycemia (27%). Although all newborn intensive care unit patients received intravenous dextrose, 22 (22%) had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82%) were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding.Conclusions:Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding.

Diabetes and Pregnancy

“…Breastfeeding immediately postpartum can be part of an early feeding strategy to reduce the risk of neonatal hypoglycemia in women with diabetes (211). Breastfeeding for more than 4 months has also been shown to be protective against the development of diabetes (OR 0.29, 95% CI 0.13-0.63) at 21 years of age in a cohort of 3,595 young adults (212).…”

“…Breastfeeding. Women with GDM should be encouraged to breastfeed immediately after delivery and for at least 4 months postpartum, as this may contribute to the reduction of neonatal hypoglycemia (211) and offspring obesity (215), and prevent the development of metabolic syndrome and type 2 diabetes in the mother (214,(389)(390)(391)(392)(393)(394)(395)(396)(397). Longer duration and more intense breastfeeding is associated with less diabetes in the mother with hazard ratios as low as 0.43 (395).…”

Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥35 weeks

“… To be given the opportunity to breastfeed as soon as possible after the delivery . If the mother cannot give breast milk or does not aim to breastfeed, infant formula is suggested to be given instead.…”

“… born LGA where the mother did not have diabetes Consensus recommendation born AGA and the mother had a diet‐treated gestational diabetes Level of evidence: low.…”

“…• To be given the opportunity to breastfeed as soon as possible after the delivery. 37 • To be kept warm. Prevent hypothermia.…”