DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192027

Glycemic status in exclusively breast fed low birth weight babies In first 72 hours of life in a teriary care hospital

Vithal Rao S. Natta, Deepthi Pagali, Venkata Priyanka Dandugula, Sowjanya Bhanu Veera

Abstract


Background: Neonatal hypoglycaemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. It can lead to considerable mortality and morbidity with long term neurological sequelae. Adequate breast feeding play an important role in maintaining normal glucose levels. So, this study is done to assess the incidence of hypoglycaemia in exclusively breast fed low birth weight babies, both term and preterm neonates and evaluate the impact of early breast feeding on glycaemic status upto 72 hours of life.

Methods: This study was conducted over 12 month period involving 236 AGA (Appropriate for gestational age), SGA (Small for gestational age) babies with birth weight between 1.6-2.49 kg. Blood glucose values were measured at birth, 3h, 6h, 12h, 24h, 48h and 72h of life after delivery which was independent of feeding time. Hypoglycaemia was assessed against age of onset, gestational age, sex of baby, mode of delivery and time of initiation of breast feeding.

Results: Total 56 episodes of hypoglycaemia were recorded in 52 babies of which 46 (27%) were term SGA babies and 6(8%) were preterm AGA babies (p=0.00148). The incidence of hypoglycaemia was found to be 22%, highest during the first 24 hours of life (93%) and delayed breast feeding is the most commonly noted risk factor (p=0.00024).

Conclusions: Low birth babies are more prone to develop hypoglycaemia especially in first 24 hours of life with delayed introduction of breast feeding being one of the common risk factors and asymptomatic hypoglycaemia can be managed with frequent breast feeding without any formula feeds.


Keywords


AGA, Breast feeding, Hypoglycaemia, Low birth weight, SGA

Full Text:

PDF

References


Adamkin DH. Postnatal Glucose Homeostasis in Late preterm and term neonates. A clinical report from American Academy of Paediatrics, Committee on Foetus and New-born Paediatrics. Pediatr. 2011;127:575-9.

Jain V, Chen M, Menon RK. Disorders of carbohydrate metabolism. In: Gleason CA, Devaskar SU eds. Avery’s Diseases of the new-born. 9th ed. Philadelphia: Saunders; 2012:1320-21.

Haninger NC, Farley CL. Screening for hypoglycaemia in healthy term neonates: effects on breastfeeding. J Midwifery Women’s Health. 2001;46(5):292-01

Stanley CA, Baker L. The causes of neonatal hypoglycaemia. N Engl J Med. 1999;340(15):1200-01.

World Health Organization. Hypoglycaemia of the new-born: Review of the Literature. Geneva: WHO/CHD/97. 1997;(1):1-55.

Nancy W, Kathleen AM. The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol 1: Guidelines for glucose monitoring and treatment of hypoglycaemia in breastfed neonates. Breastfeed Med. 2006;1:178-84.

National Family Health survey. Available at: http://rchiips.org/nfhs/NFHS-4Reports/India.pdf.

Lubchenco LO, Bard H. Incidence of hypoglycaemia in new-born infants classified by birth weight and gestational age. Paediatr. 1971;47(5):831-8.

De AK, Samanta M, Kundu CK. Study of blood glucose levels in normal and low birth weight neonates and impact of early breast feeding in a tertiary care centre. Ann Nigerian Med. 2011;51(2):53-58.

Bhat MA, Kumar P, Bhansali A, Majumdar S, Narang A. Hypoglycemia in small for gestational age babies. Indian J Pediatr. 2000;67:423-7.

Osier FH, Berkley JA, Ross A, Sanderson F, Mohammed S, Newton CR. Abnormal blood glucose concentrations on admission to a rural Kenyan district hospital: Prevalence and outcome. Arch Dis Child. 2003;88:621-5.

Hawdon JM, Ward Platt MP, Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child. 1992;67:357-65.

Diwakar KK, Sasidhar MV. Plasma glucose levels in term neonates who are appropriate size for gestation and exclusively breast fed. Arch Dis Childhood Fetal Neonatal Ed. 2002;87(1):F46-8.

Duvanel CB, Fawer CL, Cotting J, Hohlfeld P, Matthieu JM. Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants. J Pediatr. 1999;134(4):492-8.

Sasidharan CK, Gokul E, Sabitha S. Incidence and risk factors for neonatal hypoglycaemia in Kerala, India. Ceylon Med J. 2004;49(4):110-3.

Amarendra M, Sethi RK, Pericherla VP. Incidence of hypoglycaemia within 72 hours after birth in low birth weight babies who are appropriate for gestational age. Int J Contemp Pediatr. 2018;5:944-8.