Sardar Subhasis, Devgan Amit, Shaw Subhash Chandra, Mohan Karthik Ram, Roy Shuvendu
Resident (Pediatrics), Command Hospital (Eastern Command), Kolkata, India.
Professor & Head, Department of Pediatrics, Armed Forces Medical College, Pune, India.
Med J Armed Forces India. 2023 Mar-Apr;79(2):152-156. doi: 10.1016/j.mjafi.2020.10.002. Epub 2020 Dec 29.
Neonates at risk of hypoglycemia are often roomed in with mothers, but there is paucity of literature on the occurrence of hypoglycemia in these exclusively breastfed high-risk neonates. The primary objective was to estimate the incidence of hypoglycaemia in high-risk neonates on exclusive breastfeeding. The secondary objectives were to study the time of presentation, symptoms of hypoglycaemia, and the various maternal and neonatal risk factors.
This prospective observational study was carried out in a tertiary care teaching hospital of eastern India between January 2017 and June 2018. All neonates roomed in with mothers with high-risk factors such as low birth weight, preterm, small for gestational age, large for gestational age and infants of diabetic mothers were included. All included neonates were exclusive breastfed and underwent blood glucose monitoring at 2, 6, 12, 24, 48 and 72 h of life using glucometer strips and also whenever clinical features suggested hypoglycaemia. Hypoglycemia was defined as the blood glucose level ≤46 mg/dL.
Of a total of 250 neonates studied, 52 (20.8%) developed hypoglycaemia in first 72 h. Hypoglycaemia was detected in most at 2 h with the second peak at 48 h of age. Only 8 (3.2%) neonates had symptomatic hypoglycaemia with jitteriness being the commonest symptom, followed by lethargy and poor feeding.
There is a need to closely monitor the blood glucose levels for at least first 48 h in high-risk neonates roomed in with mothers on exclusive breastfeeding.
有低血糖风险的新生儿通常与母亲同住一室，但关于这些纯母乳喂养的高危新生儿低血糖发生情况的文献较少。主要目的是估计纯母乳喂养的高危新生儿低血糖的发生率。次要目的是研究低血糖出现的时间、症状以及各种母婴风险因素。
这项前瞻性观察性研究于2017年1月至2018年6月在印度东部的一家三级护理教学医院进行。纳入所有与有低出生体重、早产、小于胎龄、大于胎龄以及糖尿病母亲的婴儿等高危因素的母亲同住一室的新生儿。所有纳入的新生儿均纯母乳喂养，并在出生后2、6、12、24、48和72小时使用血糖仪试纸进行血糖监测，且每当临床特征提示低血糖时也进行监测。低血糖定义为血糖水平≤46mg/dL。
在总共研究的250例新生儿中，52例（20.8%）在出生后72小时内发生低血糖。大多数低血糖在出生后2小时被检测到，第二个高峰在48小时龄。只有8例（3.2%）新生儿有症状性低血糖，最常见的症状是震颤，其次是嗜睡和喂养不良。
对于与母亲同住一室的纯母乳喂养高危新生儿，需要至少在出生后48小时密切监测血糖水平。
