August 28, 2001
Hypoglycemia
Question from Chicago, Illinois, USA:
My one week old daughter has been in the intensive care unit with blood sugar levels of 39-70 mg/dl [mmol/L] since birth. She’s had three IV’s because they keep getting infiltrated after which her blood sugar level drops and the next is started. The doctors have been alternating each feeding between high calorie formula and my wife’s breast milk (yielding the blood sugar levels noted above). They did a chromosome test, but told us the results won’t be back for ten days (four days from now). The doctor seems to be hoping her levels will rise and stabilize. At what point do I begin to worry that it won’t? Is there anything I should have my doctor look for? Is there some other test they can do?
My wife had pre-eclampsia so they induced her at 37 weeks. My daughter weighed 8 pounds 2 ounces and was 21 inches long. She’s had a nasogastric tube twice (and now currently) because she’s feeding poorly. She’s currently receiving phototherapy, and her bilirubin count was 11.1 this morning. Her stool has improved every day. My wife received magnesium and pitocin before delivery, and my daughters magnesium level was high at first — her last lab showed it at 2.5.
Answer:
I think the most simple and best answer to your question is a recommendation that you ask the ICU to request a pediatric endocrinology consult to evaluate the hypoglycemia which appears to be mild from the numbers you give. This will allow someone right at the bedside to see your child and evaluate all the lab data. If you are in an ICU in the Chicago area, there will be a pediatric endocrinologist on staff.
LD
