Study of blood glucose level in normal and low birth weight newborns and impact of early breast feeding in a tertiary care centre

Abstract

A B S T R A C TBackground and Objectives: Neonatal hypoglycemia, a common metabolic problem, often goes unnoticed owing to lack of specifi c symptoms. We designed this study to assess the incidence of hypoglycemia in healthy normal birth weight and low birth weight babies, including both preterm and small for gestational age (SGA) newborns, to evaluate the impact of early breastfeeding on hypoglycemia and to assess the impact of exclusive breast feeding on glucose values up to 48 h of age. Design and Settings: A hospital-based prospective longitudinal study. Materials and Methods: The study was conducted over six months involving one hundred fi fty healthy (both term and preterm) appropriate for gestational age (AGA) or SGA babies with birth weight between 1.5 kg and 3.99 kg. Blood glucose values were measured at the age of 1 h, 6 h, 12 h, 24 h and 48 h after delivery which was independent of feeding time. Blood glucose value less than 40 mg/dl (2.2 mmol/l) was defi ned as hypoglycemia. Sick newborns, those less than 34 weeks of gestation or less than 1500 g, infant of diabetic mother, those with birth asphyxia, congenital malformations and endocrine defi ciencies were excluded. Results: Overall incidence of hypoglycemia was 32%. Hypoglycemia was signifi cantly greater in SGA and preterm as compared to AGA and term newborns respectively (P<0.001). Incidence of hypoglycemia was signifi cantly more in newborns with delayed breast feeding than early breast feeding (64% vs 17%; P<0.001). Conclusion: Low birth weight babies (both preterm and small-for-date) are prone to develop hypoglycemia especially in fi rst 24 h of life with delayed introduction of breast feeding being an additional risk.

Incidence of hypoglycaemia within 72 hours after birth in low birth weight babies who are appropriate for gestational age

“…In a study by Arun Kumar De et al, found that overall incidence of hypoglycaemia in healthy breastfed new-borns was 32% and the blood glucose values increased as their hours of life increased. 12 Maximum numbers of cases of hypoglycaemia were seen within the first 24 hr of age. 17 neonates had low glucose concentration at 1 hr, 33 neonates at 6 hr and 12 neonates at 12 hr and none of neonates had hypoglycaemia at 24 hr and 48 hr of age.…”

Asphyxia as a Risk Factor for Neonatal Hypoglycemia

“…De et al demonstrated higher hypoglycemia prevalence among low birth weight infants compared to normal birth weight newborn. Moreover, mean of blood glucose levels of low birth weight infants were lower than normal weight infants at 1, 6, 12, and 24 hour(s) after birth 13 . Other study reported a high prevalence (52%) of hypoglycemia among low birth weight infant and newborn with birth weight less than 10 th percentile 14 .…”

“…In order to maintain the normoglycemic condition, newborn needs suffi cient glycogen storage, maturation of glycogenolytic and gluconeogenic pathway, as well as integration of endocrine response. The increase of adrenalin secretion and rapid decrease of insulin-glucagon ratio within the fi rst hour of life, stimulate glucose release and fat metabolism from peripheral storage 13 .…”

Hypoglycemia in Newborns with risk factors of hypoglycemia.

“…10 The incidence of hypoglycemia was56.9% in present work while Kumar TJ et al 6 The incidence of hypoglycemia in low birth weight newborns was 39.4%. Singh et al 10 study showed incidence of hypoglycemia in low birth weight newborns 29.5%, De AK et al 13 showed 64.8% incidence of hypoglycemia in low birth weight newborns but the population size was small. 13 We noted 29.4% newborns to have born with maternal history of Diabetes.…”