Hypoglycemia in breastfed neonates: a hospital-based study


  • Abhishek Chakraborty Department of Pediatrics, Jivan Jyoti Institute of Medical Sciences, Silchar Assam, India
  • Monika Deb Department of Obstetrics and Gynecology, Jivan Jyoti Institute of Medical Sciences, Silchar Assam, India




Hypoglycemia, Capillary blood glucose, Incidence, Neonates, Breastfeeeding


Background: Neonates has well-coordinated adaptation system which maintains the blood sugar at certain safe level in extra uterine life. However certain intrauterine risk factors alter this adaptation system leading to hypoglycemia in early post-natal period. Most of the time hypoglycemic episodes are transient but sometimes there may be recurrent or prolonged hypoglycemia leading to permanent insult in brain and neurological deficit in post-natal life. Aims and objective of the study was to find out incidence of hypoglycemia in exclusively breastfeed neonates and the risk factors associated with this in the post-natal ward of a tertiary care centre in North-East India.

Methods: This is a prospective study conducted for a period of six month, where 112 exclusively breastfeed neonates who were shifted immediately to post-natal ward were included. Capillary blood sugar was checked at 1, 3, 6, 12, 24, 48 and 72 hours of life. Neonates with capillary blood glucose less than 40 were considered hypoglycemic. All the hypoglycemic babies were extensively evaluated for different intrauterine and post-natal risk factors.

Results: Incidence of hypoglycemia was 16% (18 out of 112 babies). Significant numbers (30.5%) of LBW babies had hypoglycemia, where as 6.5% of normal birth weight babies had hypoglycemia. 38.8% of preterm babies had hypoglycemia where as 11.95% of term babies had hypoglycemic episodes. 71.4% (5 out of 7 babies) of neonates born from diabetic mother. All the large for date infants of diabetic mother had hypoglycemia.

Conclusions: Our study came to a conclusion that incidence of hypoglycemia is not very uncommon finding in exclusively breastfeed neonates especially those with risk factors. Routine capillary blood glucose screening is utmost important to pick up the babies with hypoglycemia to prevent immediate and long-term complication.


Wight NE. Hypoglycemia in Breastfed Neonates. Breastfeeding Medicine. 2006;1(4):253-62.

Sperling MA, Menon RK. Differential diagnosis and management of neonatal hypoglycemia. Pediatr Clin North Am. 2004;51:703-23.

Menon RK, Sperling MA. Carbohydrate metabolism in neonatal adaptation: the transition to post-natal life. Semin Perinatol. 1988;12:157-62.

Stanley CA. Dissecting the spectrum of fatty acid oxidation disorders. J Pediatr. 1998;132: 384-6.

Stanley CA, Baker L. The causes of neonatal hypoglycemia. N Engl J Med. 1999;340:1200-1.

Sperling MA, Menon RK. Hyperinsulinemic hypoglycemia of infancy: recent insights into ATP sensitive potassium channels, sulfonylurea receptors, molecular mechanisms, and treatments. Endocrinol Metab Clin North Am. 1999;4:695-708.

Hawdon JM. Hypoglycaemia and the neonatal brain. Eur J Pediatr. 1999;158(Suppl 1):S9-12.

Menni F, deLonlay P, Sevin C, Touati G, Peigne C, Barbier V, et al. Neurologic outcomes of 90 neonates and infants with persistent hyperinsulinemic hypoglycemia. Pediatrics. 2001;3:476-9.

Harris DL, Weston PJ, Harding JE. Incidence of neonatal hypoglycemia in babies identified as at risk. J Pediatr. 2012;161:787-91.

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

Singh P, Upadhya A, Sreenivas V, Jaiswal V, Saxena P. Screening for Hypoglycemia in Exclusively Breastfed High-risk Neonates. Indian Pediatrics. 2017;54:477-80.

Turner D, Monthé-Drèze C, Cherkerzian S, Gregory K, Sen S. Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia? J Perinatol. 2019;39:1057-64.

Zhou W, Yu J, Wu Y, Zhang H. Hypoglycemia incidence and risk factors assessment in hospitalized neonates. J Matern Neonatal Med. 2015;28:422-5.

Kumar TJ, Vaideeswaran M. Incidence of hypoglycemia in newborns with risk factors. Int J Contemp Pediatr. 2018;5:1952-5.

Persson B. Neonatal glucose metabolism in offspring of mothers with varying degrees of hyperglycemia during pregnancy. Semin Fetal Neonatal Med 2009;14:106-10.

Adamkin DH. Neonatal hypoglycaemia. Seminars Fetal Neonatal Med. 2017;22:36-41.






Original Research Articles