Neonatal Hypoglycemia - Medical Malpractice Lawyers

A common metabolic problem in newborns is a condition known as neonatal hypoglycemia. The condition is present whenever there is a blood sugar level of less than 30 mg/dl for the first day following birth, less than 45 mg/dL for the second day following birth, and is found in 1.3 to 3 percent of all newborns. Neonatal hypoglycemia is more common in babies who are of a larger size, who may have had an infection, who had some type of fetal distress, or those who had a diabetic mother. In some cases the condition may have no symptoms, but there may be heart, respiratory, or central nervous system issues. Many cases show signs of vomiting, lethargy, irritability, and an altered mental state.

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Neonatal Hypoglycemia is a condition that can cause damage to the brain and subsequent physical and mental impairment. There is an increased risk shortly after birth for children of insulin dependent mothers, babies with growth retardation, preterm and asphyxiated infants. Doctors often do not recognize the symptoms of neonatal hypoglycemia and as a result do not take appropriate action to prevent brain damage.

Brain Damage

Serious developmental issues can result if the baby has been exposed to repeated hypoglycemia, which can have a negative impact on the brain. The condition can worse, and cause brain damage if there has been a lack of oxygen, lack of blood, hypoxia, or ischemia.

Risk Factors

Newborns weighing more than four kilograms or less than two kilograms are at an increased risk for hypoglycemia. Nearly one in one thousand pregnant women is diabetic and two percent of all pregnant women acquire gestational diabetes. This also increases the chances of the baby developing the condition of hypoglycemia.

Symptoms

Common symptoms associated with neonatal hypoglycemia include: seizures, a low Apgar score, jitteriness, lethargy, low feeding, rapid breathing, and a fluctuation in body temperature. If the mother took hypoglycemic medication, beta blockers, terbutaline, has an enlarged liver, or if the baby was in fetal distress, neonatal hypoglycemia needs to be looked into.

Monitoring

Anytime a baby is suspected of having hypoglycemia, regular monitoring should take place on the hour, every hour to track blood glucose levels. This should continue until the levels stabilize. If it is determined that blood sugar is too low, an IV solution containing dextrose can be given. In severe cases, anti seizure medications may be needed to control seizures that may develop. Sodium bicarbonate can also be given if acidosis is present. Acidosis is a condition that causes blood pH to be below 7.1. The main idea with any variation of treatment is to bring blood glucose level to greater than 45 mg/dL full time. With time, the baby will start to drink sugar water by him or herself, and dextrose can be added to the bottle until all levels seem to be normal.

Treatment

In order to ensure there are no serious complications or there is no permanent brain or neurological damage, hypoglycemia needs to be treated quickly. It is recommended that newborns be fed early so that blood sugar levels can rise naturally. If the baby is too lethargic to eat on his or her own, a nasogastric tube can be inserted into the throat to verify the baby’s ability to suck. Cortisol is not recommended in the course of treatment because it has been shown to be slow to react and actually mask the true cause of the hypoglycemia.

Neonatal Hypoglycemia Medical Malpractice Lawyer

Our team of medical negligence lawyers handles a wide range of personal injury cases including the physical complications of neonatal hypoglycemia. If you would like a free, no obligation consultation relating to the effects of neonatal hypoglycemia please contact us today for more information. A neonatal hypoglycemia medical malpractice lawyer will handle personal injury compensation claim settlements that deal with the issues of neonatal hypoglycemia arising when a physician has not administered proper care or treatment. If you would like to talk to one of our medical malpractice lawyers who deals with neonatal hypoglycemia compensation claims, please use the contact form on this website or email our offices. We offer free advice with no further obligation in order to protect your legal right to claim compensation for personal injury caused by negligence. Time limits apply to neonatal hypoglycemia medical malpractice lawsuits and you should take legal advice from a specialist medical malpractice lawyer as soon as possible after the negligent event that caused your injury. Please contact us today to find out how we can help.

Neonatal Hypoglycemia Overview

Neonatal hypoglycaemia is low blood sugar or low blood glucose in the first hours or days of life. It is a problem common to women who have diabetes, women who have gestational diabetes and women who have very large infants. Glucose normally provides the body energy and is the only energy source for the brain. Glucose is necessary to make sure the brain gets the nutrition it needs.

Glucose in utero is given through the placenta. The mother's bloodstream is filled with glucose that passes through the placenta and is processed via the infant's pancreas, which makes insulin in response to the sugar it gets. This normalizes the infant blood sugar even if the mother's blood sugar is high. When the infant is finally born, its pancreas is still going at a rate expecting a high blood sugar to be presented to it. This doesn't happen after the baby is born and the overactive pancreas lowers the blood sugar to dangerous levels. The baby needs some kind of glucose to counteract the elevated insulin levels in the baby. This lets the pancreas slowly normalize its overdriven rate.

Fortunately, infant formula is turned into glucose by the liver enzymes so that feeding the infant shortly after birth can take care of the problem quite quickly. If you need to treat a moderately low blood sugar, infant formula is a good treatment. If the problem is severe, oral or IV glucose is given instead.

The causes of neonatal hypoglycaemia can also be due to an enlarged pancreas in the neonate or due to poor glycogen stores in the liver. Glycogen is the way glucose is stored in the infant's liver. The baby could be ill and could be using too much glycogen to fight the illness and will have low glucose levels.

Neonatal hypoglycaemia is the most common metabolic problem in neonates. It is seen to a severe degree in 1 to 3 out of a thousand births and is seen in milder cases in many more cases.

The following conditions can lead to neonatal hypoglycaemia: bloodborne infection, intrauterine growth retardation, hypothyroidism, low oxygen during delivery, inborn errors of metabolism, large infant, gestational diabetes, diabetes type I or II in the mother, prematurity in the infant or if the baby is too small for its gestational age.

When a neonate has neonatal hypoglycaemia, nurses can note several symptoms that indicate the possibility of neonatal hypoglycaemia. There can by cyanosis or bluish coloration to the skin; there can be difficulty breathing; there can be a floppy baby with poor muscle tone; the baby may be grunting when breathing or ca be overly irritable. There may be poor feeding with a rapid breathing that is shallow in nature. The baby is often tremulous or shaking of the body along with seizures or sweating noted. The baby may also be listless and pale and may be breathing in an irregular pattern.

The blood sugar is checked any time a low blood sugar situation is suspected. If the blood sugar is lower than 40 mg/dL, the situation is neonatal hypoglycaemia. If it is less than 20 mg/dL, it is often read as "low" on a glucose monitor and immediate action needs to be taken, including IV glucose administration. Doctors need to check for the underlying cause of the disease, including inborn errors of metabolism or perhaps hypothyroidism.

If the situation is mild, the infant is given oral glucose water, oral breast milk or oral formula in order to bring up the blood sugar. IV glucose is reserved for severe cases when the infant doesn't have the ability to eat on its own. It takes several hours to treat neonatal hypoglycaemia before the infant glucose level normalizes and stays normal. It should be rechecked every few hours until it stabilizes into the normal range. Two medications can be used in severe cases. These include ocreotide or diazoxide. Diazoxide causes an increase in blood sugar levels and ocreotide lowers the insulin levels.

Prolonged low blood sugar can be dangerous and can result in seizures, heart failure and developmental delay. This is why doctors and nurses need to check the blood sugar if there are any symptoms or clinical evidence that low blood sugar might exist.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here