Abstract
Neonatal hypoglycemia (NH) is a frequent condition with diagnosis criteria and management that are still controversial. The establishment and maintenance of breastfeeding may be affected in patients with NH. To avoid neurological damage, intravenous glucose infusion is recommended for the treatment of patients with symptomatic NH. Intraoral administration of colostrum as an intervention has been little explored. We report the case of a newborn with symptomatic NH whose first intervention was oral administration of colostrum with an optimal response. CONCLUSIONS: Colostrum for management of NH is a low-cost, noninvasive intervention that encourages the establishment of lactation.
References
Abramowski, A., Ward, R., & Hamdan, A. H. (2023). Neonatal Hypoglycemia. In StatPearls. StatPearls Publishing.
Adamkin D. H. (2017). Neonatal hypoglycemia. Seminars in fetal & neonatal medicine, 22(1), 36–41. https://doi.org/10.1016/j.siny.2016.08.007
Adamkin, D. H., & Committee on Fetus and Newborn. (2011). Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics, 127(3), 575–579. https://doi.org/10.1542/peds.2010-3851
Bardanzellu, F., Fanos, V., & Reali, A. (2017). "Omics" in Human Colostrum and Mature Milk: Looking to Old Data with New Eyes. Nutrients, 9(8), 843. https://doi.org/10.3390/nu9080843
Bromiker, R., Perry, A., Kasirer, Y., Einav, S., Klinger, G., & Levy-Khademi, F. (2019). Early neonatal hypoglycemia: incidence of and risk factors. A cohort study using universal point of care screening. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 32(5), 786–792. https://doi.org/10.1080/14767058.2017.1391781
Burns, C. M., Rutherford, M. A., Boardman, J. P., & Cowan, F. M. (2008). Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics, 122(1), 65–74. https://doi.org/10.1542/peds.2007-2822
Cacciatore, M., Grasso, E. A., Tripodi, R., & Chiarelli, F. (2022). Impact of glucose metabolism on the developing brain. Frontiers in endocrinology, 13, 1047545. https://doi.org/10.3389/fendo.2022.1047545
Castillo Martínez, J. (2013). "Incidencia de hipoglucemia neonatal transitoria asintomática en recién nacidos prematuros tardíos y de término con bajo peso al nacer". [Trabajo de grado de especialización. Universidad Nacional Autónoma de México]. https://repositorio.unam.mx/contenidos/367725
Chen, Y. S., Ho, C. H., Lin, S. J., & Tsai, W. H. (2022). Identifying additional risk factors for early asymptomatic neonatal hypoglycemia in term and late preterm babies. Pediatrics and neonatology, 63(6), 625–632. https://doi.org/10.1016/j.pedneo.2022.04.011
Chiruvolu, A., Miklis, K. K., Stanzo, K. C., Petrey, B., Groves, C. G., McCord, K., Qin, H., Desai, S., & Tolia, V. N. (2017). Effects of Skin-to-Skin Care on Late Preterm and Term Infants At-Risk for Neonatal Hypoglycemia. Pediatric quality & safety, 2(4), e030. https://doi.org/10.1097/pq9.0000000000000030
Coors, S. M., Cousin, J. J., Hagan, J. L., & Kaiser, J. R. (2018). Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A Quasi-Experimental Pilot Study. The Journal of pediatrics, 198, 156–161. https://doi.org/10.1016/j.jpeds.2018.02.025
Cuper, N. J., de Graaff, J. C., van Dijk, A. T., Verdaasdonk, R. M., van der Werff, D. B., & Kalkman, C. J. (2012). Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital. Paediatric anaesthesia, 22(3), 223–229. https://doi.org/10.1111/j.1460-9592.2011.03685.x
Dalsgaard, B. T., Rodrigo-Domingo, M., Kronborg, H., & Haslund, H. (2019). Breastfeeding and skin-to-skin contact as non-pharmacological prevention of neonatal hypoglycemia in infants born to women with gestational diabetes; a Danish quasi-experimental study. Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, 19, 1–8. https://doi.org/10.1016/j.srhc.2018.10.003
Covas, M., Qintana, D., Oviedo, B., Medina, M., Gurrea, M., Miyar, A., & Alda, E. (2023). Hipoglucemia neonatal: eficacia de la glucosa gel en el tratamiento de la hipoglucemia precoz en recién nacidos con factores de riesgo. Ensayo clínico aleatorizado. Andes Pediatrica, 94(1), 70-77. doi:http://dx.doi.org/10.32641/andespediatr.v94i1.4220
Edwards, T., Liu, G., Battin, M., Harris, D. L., Hegarty, J. E., Weston, P. J., & Harding, J. E. (2022). Oral dextrose gel for the treatment of hypoglycaemia in newborn infants. The Cochrane database of systematic reviews, 3(3), CD011027. https://doi.org/10.1002/14651858.CD011027.pub3
Elbeltagi, R., Al-Beltagi, M., Saeed, N. K., & Bediwy, A. S. (2023). Cardiometabolic effects of breastfeeding on infants of diabetic mothers. World journal of diabetes, 14(5), 617–631. https://doi.org/10.4239/wjd.v14.i5.617
Filan, P. M., Inder, T. E., Cameron, F. J., Kean, M. J., & Hunt, R. W. (2006). Neonatal hypoglycemia and occipital cerebral injury. The Journal of pediatrics, 148(4), 552–555. https://doi.org/10.1016/j.jpeds.2005.11.015
Forster, D. A., Moorhead, A. M., Jacobs, S. E., Davis, P. G., Walker, S. P., McEgan, K. M., Opie, G. F., Donath, S. M., Gold, L., McNamara, C., Aylward, A., East, C., Ford, R., & Amir, L. H. (2017). Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. Lancet (London, England), 389(10085), 2204–2213. https://doi.org/10.1016/S0140-6736(17)31373-9
Foudil-Bey, I., Murphy, M. S. Q., Dunn, S., Keely, E. J., & El-Chaâr, D. (2021). Evaluating antenatal breastmilk expression outcomes: a scoping review. International breastfeeding journal, 16(1), 25. https://doi.org/10.1186/s13006-021-00371-7
Fujimori, M., França, E. L., Fiorin, V., Morais, T. C., Honorio-França, A. C., & de Abreu, L. C. (2015). Changes in the biochemical and immunological components of serum and colostrum of overweight and obese mothers. BMC pregnancy and childbirth, 15, 166. https://doi.org/10.1186/s12884-015-0574-4
Fujimori, M., França, E. L., Morais, T. C., Fiorin, V., de Abreu, L. C., & Honório-França, A. C. (2017). Cytokine and adipokine are biofactors can act in blood and colostrum of obese mothers. BioFactors (Oxford, England), 43(2), 243–250. https://doi.org/10.1002/biof.1339
Giouleka, S., Gkiouleka, M., Tsakiridis, I., Daniilidou, A., Mamopoulos, A., Athanasiadis, A., & Dagklis, T. (2023). Diagnosis and Management of Neonatal Hypoglycemia: A Comprehensive Review of Guidelines. Children (Basel, Switzerland), 10(7), 1220. https://doi.org/10.3390/children10071220
Glasgow, M. J., Edlin, R., & Harding, J. E. (2020). Cost-Utility Analysis of Prophylactic Dextrose Gel vs Standard Care for Neonatal Hypoglycemia in At-Risk Infants. The Journal of pediatrics, 226, 80–86.e1. https://doi.org/10.1016/j.jpeds.2020.06.073
Gregory, K., Turner, D., Benjamin, C. N., Monthe-Dreze, C., Johnson, L., Hurwitz, S., Wolfsdorf, J., & Sen, S. (2020). Incorporating dextrose gel and feeding in the treatment of neonatal hypoglycaemia. Archives of disease in childhood. Fetal and neonatal edition, 105(1), 45–49. https://doi.org/10.1136/archdischild-2018-316430
Harding, J. E., Hegarty, J. E., Crowther, C. A., Edlin, R. P., Gamble, G. D., Alsweiler, J. M., & hPOD Study Group (2021). Evaluation of oral dextrose gel for prevention of neonatal hypoglycemia (hPOD): A multicenter, double-blind randomized controlled trial. PLoS medicine, 18(1), e1003411. https://doi.org/10.1371/journal.pmed.1003411
Haninger, N. C., & Farley, C. L. (2001). Screening for hypoglycemia in healthy term neonates: effects on breastfeeding. Journal of midwifery & women's health, 46(5), 292–301. https://doi.org/10.1016/s1526-9523(01)00180-5
Hosagasi, N. H., Aydin, M., Zenciroglu, A., Ustun, N., & Beken, S. (2018). Incidence of hypoglycemia in newborns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia. Pediatrics and neonatology, 59(4), 368–374. https://doi.org/10.1016/j.pedneo.2017.11.009
Johnsen, M., Klingenberg, C., Brand, M., Revhaug, A., & Andreassen, G. (2021). Antenatal breastmilk expression for women with diabetes in pregnancy - a feasibility study. International breastfeeding journal, 16(1), 56. https://doi.org/10.1186/s13006-021-00393-1
Karbalivand, H., Iyare, A., Aponte, A., Xianhong, X., Kim, M., & Havranek, T. (2022). Hypoglycemia screening of asymptomatic newborns on the 2nd day of life. Journal of neonatal-perinatal medicine, 15(2), 311–316. https://doi.org/10.3233/NPM-210861
Khan, I., Muhammad, T., & Khan, M. (2010). Frequency and Clinical Characteristics of Symptomatic Hypoglycemia in Neonates. Gomal Journal of Medical Sciences, 8(2). Retrieved from https://www.gjms.com.pk/index.php/journal/article/view/329/326
Kumar, J., Meena, J., Ranjan, A., & Kumar, P. (2023). Oropharyngeal application of colostrum or mother's own milk in preterm infants: a systematic review and meta-analysis. Nutrition reviews, 81(10), 1254–1266. https://doi.org/10.1093/nutrit/nuad002
Lawrence RA & Lawrence RM. (2022). Breastfeeding : A Guide for the Medical Profession. Ninth ed. Philadelphia PA: 360 Elsevier. https://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-C20140021363
Maternity Services Lothian (2023). Antenatal Hand Expressing. accessed 2024 at: 362 https://www.anchb.scot.nhs.uk/media/lhwljysc/hand-expressing-2023-updated.pdf
Meneghin, F., Manzalini, M., Acunzo, M., Daniele, I., Bastrenta, P., Castoldi, F., Cavigioli, F., Zuccotti, G. V., & Lista, G. (2021). Management of asymptomatic hypoglycemia with 40% oral dextrose gel in near term at-risk infants to reduce intensive care need and promote breastfeeding. Italian journal of pediatrics, 47(1), 201. https://doi.org/10.1186/s13052-021-01149-7
Mukhopadhyay, S., Wade, K. C., Dhudasia, M. B., Skerritt, L., Chou, J. H., Dukhovny, D., & Puopolo, K. M. (2020). Clinical impact of neonatal hypoglycemia screening in the well-baby care. Journal of perinatology : official journal of the California Perinatal Association, 40(9), 1331–1338. https://doi.org/10.1038/s41372-020-0641-1
Neville, M. C., Morton, J., & Umemura, S. (2001). Lactogenesis. The transition from pregnancy to lactation. Pediatric clinics of North America, 48(1), 35–52. https://doi.org/10.1016/s0031-3955(05)70284-4
Pérez G, Meritano J, Rubio C, Gutierrez S, Mariani M, Brener P, Sabatelli D, Scaramutti M. (2019). Comité de Estudios Feto-Neonatales. Hipoglucemia neonatal: revisión de las prácticas habituales. Archivos Argentinos de Pediatría , 117 Supl 5:S195-S204. http://dx.doi.org/10.5546/aap.2019.S195
Quiros-Lamadrid D, Guzmán-Anaya GA, Almonte Lemus LA, Ceja-Mejia OE, Arias-Uribe BN, Ruelas-Arana E, Gutierrez-375 Padilla JA, Gallego-Tapia AR, López-Romero JA, Mercado-Cerda JI. (2020). Hipoglucemia del recién nacido de 376 riesgo en las primeras 24 horas de vida. Revista Médica MD, 11(2):87-91. 377 https://revistamedicamd.com/aj./webmaster/getfile/a9473f7fc728bfb1ab088104f198c300/
Roberts, L., Lin, L., Alsweiler, J., Edwards, T., Liu, G., & Harding, J. E. (2023). Oral dextrose gel to prevent hypoglycaemia in at-risk neonates. The Cochrane database of systematic reviews, 11(11), CD012152. https://doi.org/10.1002/14651858.CD012152.pub4
Stanzo, K., Desai, S., & Chiruvolu, A. (2020). Effects of Dextrose Gel in Newborns at Risk for Neonatal Hypoglycemia in a Baby-Friendly Hospital. Journal of obstetric, gynecologic, and neonatal nursing: JOGNN, 49(1), 55–64. https://doi.org/10.1016/j.jogn.2019.11.006
Stewart, C. E., Sage, E. L., & Reynolds, P. (2016). Supporting 'Baby Friendly': a quality improvement initiative for the management of transitional neonatal hypoglycaemia. Archives of disease in childhood. Fetal and neonatal edition, 101(4), F344–F347. https://doi.org/10.1136/archdischild-2015-308950
Thornton, P. S., Stanley, C. A., De Leon, D. D., Harris, D., Haymond, M. W., Hussain, K., Levitsky, L. L., Murad, M. H., Rozance, P. J., Simmons, R. A., Sperling, M. A., Weinstein, D. A., White, N. H., Wolfsdorf, J. I., & Pediatric Endocrine Society (2015). Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children. The Journal of pediatrics, 167(2), 238–245. https://doi.org/10.1016/j.jpeds.2015.03.057
Tozier P. K. (2013). Colostrum versus formula supplementation for glucose stabilization in newborns of diabetic mothers. Journal of obstetric, gynecologic, and neonatal nursing: JOGNN, 42(6), 619–628. https://doi.org/10.1111/1552-6909.12260
Turner, D., Monthé-Drèze, C., Cherkerzian, S., Gregory, K., & Sen, S. (2019). Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia?. Journal of perinatology : official journal of the California Perinatal Association, 39(8), 1057–1064. https://doi.org/10.1038/s41372-019-0404-z
van Kempen, A. A. M. W., Eskes, P. F., Nuytemans, D. H. G. M., van der Lee, J. H., Dijksman, L. M., van Veenendaal, N. R., van der Hulst, F. J. P. C. M., Moonen, R. M. J., Zimmermann, L. J. I., van 't Verlaat, E. P., van Dongen-van Baal, M., Semmekrot, B. A., Stas, H. G., van Beek, R. H. T., Vlietman, J. J., Dijk, P. H., Termote, J. U. M., de Jonge, R. C. J., de Mol, A. C., Huysman, M. W. A., … HypoEXIT Study Group (2020). Lower versus Traditional Treatment Threshold for Neonatal Hypoglycemia. The New England journal of medicine, 382(6), 534–544. https://doi.org/10.1056/NEJMoa1905593
WHO Immediate KMC Study Group, Arya, S., Naburi, H., Kawaza, K., Newton, S., Anyabolu, C. H., Bergman, N., Rao, S. P. N., Mittal, P., Assenga, E., Gadama, L., Larsen-Reindorf, R., Kuti, O., Linnér, A., Yoshida, S., Chopra, N., Ngarina, M., Msusa, A. T., Boakye-Yiadom, A., Kuti, B. P., … Massawe, A. (2021). Immediate "Kangaroo Mother Care" and Survival of Infants with Low Birth Weight. The New England journal of medicine, 384(21), 2028–2038. https://doi.org/10.1056/NEJMoa2026486
Wight, N. E., & Academy of Breastfeeding Medicine (2021). ABM Clinical Protocol #1: Guidelines for Glucose Monitoring and Treatment of Hypoglycemia in Term and Late Preterm Neonates, Revised 2021. Breastfeeding medicine: the official journal of the Academy of Breastfeeding Medicine, 16(5), 353–365. https://doi.org/10.1089/bfm.2021.29178.new
Zhao, T., Liu, Q., Zhou, M., Dai, W., Xu, Y., Kuang, L., Ming, Y., & Sun, G. (2020). Identifying risk effectors involved in neonatal hypoglycemia occurrence. Bioscience reports, 40(3), BSR20192589. https://doi.org/10.1042/BSR20192589
Zhou, W., Yu, J., Wu, Y., & Zhang, H. (2015). Hypoglycemia incidence and risk factors assessment in hospitalized neonates. The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 28(4), 422–425. https://doi.org/10.3109/14767058.2014.918599
Revista Bio Ciencias by Universidad Autónoma de Nayarit under Creative Commons Attribution-NonCommercial 3.0 Unported License.
Based on work of http://biociencias.uan.edu.mx/.
Further permits not covered by this licence can be found at http://editorial.uan.edu.mx/index.php/BIOCIENCIAS.