Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand.
Liggins Institute, University of Auckland, Auckland, New Zealand.
Neonatology. 2019;115(3):234-238. doi: 10.1159/000494998. Epub 2019 Jan 22.
Feeding is often used for the initial treatment of hypoglycaemia, but it is not known if pre-feed alertness and observed quality of breastfeeding are related to the subsequent change in blood glucose concentration.
We sought to determine if assessment of pre-feed alertness and the observed quality of the breastfeed were related to the subsequent change in blood glucose concentration in hypoglycaemic babies.
Babies were ≥35 weeks, ≤48 h old, identified as being at-risk for hypoglycaemia (infants of diabetic mothers, small [< 2,500 g or < 10th centile] or large [birthweight > 4,500 g or > 90th centile] birthweight) and hypoglycaemic (< 2.6 mM). Midwives assessed pre-feed alertness and quality of feeding at each hypoglycaemic episode. Change in blood glucose concentration was assessed within 15-90 min.
One hundred and thirty-one babies had 163 hypoglycaemic episodes. Babies assessed as alert had a greater increase in blood glucose concentration than sleepy babies (mean [95% CI] awake 0.71 [0.61-0.82] vs. sleepy 0.51 [0.35-0.66] mM, p = 0.04). The change in blood glucose concentration was similar after feeds of different observed quality (offered, 0.50 [0.29-0.72], latched, 0.66 [0.52-0.81], swallowing 0.65 [0.54-0.76] mM, p = 0.13).
Observed quality of breastfeeding is not a useful predictor of the change in blood glucose concentration in hypoglycaemic babies.
喂养常被用于治疗低血糖的初始阶段，但目前尚不清楚喂奶前的警觉性和观察到的母乳喂养质量是否与随后血糖浓度的变化有关。
我们旨在确定低血糖婴儿的喂奶前警觉性评估和观察到的母乳喂养质量是否与随后血糖浓度的变化相关。
婴儿≥35 周，≤48 小时，被认为有低血糖风险（糖尿病母亲的婴儿、小（<2500g 或<第 10 百分位数）或大（出生体重>4500g 或>第 90 百分位数）出生体重）和低血糖（<2.6mM）。助产士在每次低血糖发作时评估喂奶前的警觉性和喂养质量。在 15-90 分钟内评估血糖浓度的变化。
131 名婴儿有 163 次低血糖发作。警觉的婴儿血糖浓度升高幅度大于困倦的婴儿（清醒时平均[95%CI]升高 0.71[0.61-0.82] vs. 困倦时升高 0.51[0.35-0.66] mM，p=0.04）。观察到的不同母乳喂养质量的血糖浓度变化相似（提供的为 0.50[0.29-0.72]，衔接的为 0.66[0.52-0.81]，吞咽的为 0.65[0.54-0.76] mM，p=0.13）。
观察到的母乳喂养质量不是预测低血糖婴儿血糖浓度变化的有用指标。
