See also Guideline on Management of Hypoglycaemia

See also Hypoglycaemia on the Postnatal Ward

This guideline refers to term or near-term babies who are:

• <10th or >95th centile by customised centile charts, or
• <2.5kg or >4.5kg if customised centiles are not available

These babies are at risk of:

• hypoglycaemia
• hypothermia
• jaundice secondary to polycythaemia

1. Temperature should be monitored before feeds for 12 hours or until stable
2. Baby should be closely observed for signs of hypoglycaemia or hypothermia (e.g jitteriness, pallor, lethargy).
3. Routine blood glucose measurement should have been requested by the LMC or Paediatrician within the first hour following birth and 4-hourly or pre-feed thereafter (whichever comes first).
   • All blood glucose measurements should be performed by the Laboratory.
   • That is, bedside testing methods (BM-stix, Precision-G monitors) are not reliable at detecting hypoglycaemia.
4. Feeding should be commenced early; first feed within one hour of delivery and thereafter at least 3 hourly.
   • Either breast or formula feeds (maternal preference) can be given.
   • Complement feeds are not necessary unless the babies blood glucose falls to <2.6mmol/L.
5. The baby should be watched for jaundice and bilirubin levels measured as indicated.