Weston Philip J, Harris Deborah L, Harding Jane E
Department of Paediatrics, Waikato Hospital, Hamilton, New Zealand.
Liggins Institute, University of Auckland, Auckland, New Zealand.
Arch Dis Child Fetal Neonatal Ed. 2017 Nov;102(6):F539-F541. doi: 10.1136/archdischild-2017-312772. Epub 2017 May 23.
Dextrose gel is increasingly used as first-line treatment for neonatal hypoglycaemia. Treatment with 400 mg/kg previously has been reported to impair subsequent feeding. We sought to determine if the recommended dose of 200 mg/kg altered feeding.
Hypoglycaemic babies were randomised to 200 mg/kg dextrose gel or placebo and fed. Prefeed alertness, quality and duration of breast feeding, and the volume of formula taken were assessed on the next feeding.
Prefeed alertness scores were similar in babies (n=211) treated with dextrose or placebo gel (124 episodes, OR=1.30 (95% CI 0.62 to 2.77), p=0.49). Breastfed babies were more likely to have good feeding scores after dextrose gel (160 episodes, OR=3.54 (95% CI 1.30 to 9.67), p=0.01) but similar breastfeeding duration (57 episodes, median (range) 20 (3-90) vs 25 (2-80) min, p=0.62). Formula volumes taken were also similar (24 episodes, median (range) 4.6 (2.2-11.3) vs 6.4 (2.0-8.9) mL/kg, p=0.30).
Treating hypoglycaemic babies with dextrose gel 200 mg/kg does not depress subsequent feeding and may improve breastfeeding quality.
ACTRN 12608000623392.
葡萄糖凝胶越来越多地被用作新生儿低血糖的一线治疗方法。此前有报道称，400mg/kg的治疗剂量会影响后续喂养。我们试图确定推荐剂量200mg/kg是否会改变喂养情况。
将低血糖婴儿随机分为接受200mg/kg葡萄糖凝胶治疗组或安慰剂组，并进行喂养。在下次喂养时评估喂养前的警觉性、母乳喂养的质量和持续时间以及配方奶摄入量。
接受葡萄糖或安慰剂凝胶治疗的婴儿（n = 211）的喂养前警觉性评分相似（124次事件，OR = 1.30（95%CI 0.62至2.77），p = 0.49）。母乳喂养的婴儿在接受葡萄糖凝胶治疗后更有可能获得良好的喂养评分（160次事件，OR = 3.54（95%CI 1.30至9.67），p = 0.01），但母乳喂养持续时间相似（57次事件，中位数（范围）20（3 - 90）对25（2 - 80）分钟，p = 0.62）。配方奶摄入量也相似（24次事件，中位数（范围）4.6（2.2 - 11.3）对6.4（2.0 - 8.9）mL/kg，p = 0.30）。
用200mg/kg葡萄糖凝胶治疗低血糖婴儿不会抑制后续喂养，且可能改善母乳喂养质量。
ACTRN 12608000623392。
