Investigation, prevention and management of neonatal hypoglycaemia (impaired postnatal metabolic adaptation)

Blood glucose levels fall in the hours after birth in all babies but for most babies the normal process of neonatal metabolic adaptation mobilizes alternative fuels (eg ketone bodies) from stores so that the physiological fall in blood glucose is tolerated. However, some babies are at risk of impaired neonatal metabolic adaptation and for these babies it is important to prevent hypoglycaemia, to recognize clinically significant hypoglycaemia, and to treat it without causing unnecessary separation of mother and baby or disruption of breast feeding. Investigations for underlying cause of hypoglycaemia should be performed if hypoglycaemia is persistent, resistant or unexpected.