Objective The aims of our study were to estimate the preventive effect of early feeding in neonates at risk of developing hypoglycemia, and to estimate the effect of increasing milk volume.
Methods All 1605 neonates born in the Central Hospital in Naestved from September 1 2001 to August 31 2002 were managed according to a strict protocol. Data was collected prospectively. Five risk groups were defined: 1) Small for gestational age (SGA), 2) intrauterine growth retardation (IUGR), 3) infants of mothers with gestational diabetes, 4) asphyxia, acidosis, or sepsis, and 5) polycythemia, erythroblastosis fetalis, respiratory distress or hyperbilirubinemia. All neonates at risk received early feeding with 5 ml/kg of milk every two hours. Blood glucose was measured two hours after feeding. In case of hypoglycemia (blood glucose <2.5 mmol/l) the volume of milk was increased. If hypoglycemia persisted infants were given i.v. glucose.
Results Of the 1605 neonates, 10.5% were at risk. Prevention with early feeding was successful in 46.6% of them. 50% of the neonates who did develop hypoglycemia could be treated with increased volume of milk. Hypoglycemia occurred in all risk groups. The risk was highest in the groups “SGA” and “birth weight <2500 g”. The presence of more than one risk factor increased the risk significantly.
Conclusions More than 50% of newborns at risk developed hypoglycemia in spite of a strict preventive protocol. The clinical significance is ill-defined.