UofL neonatologist develops guidelines to prevent newborn brain damage


    LOUISVILLE, Ky. –University of Louisville neonatologist David Adamkin, M.D., working in concert with the American Academy of Pediatrics Committee on Fetus and Newborn, has developed a set of guidelines that could help save newborns from irreversible brain damage caused by neonatal hypoglycemia, a frequently invisible condition that occurs in newborns with a variety of risk factors. The guidelines were published in the March issue of the AAP journal Pediatrics.

    Healthy newborns’ blood sugar concentrations are often temporarily low for a few hours after birth. This condition, known as neonatal hypoglycemia, isn’t necessarily a risk, since many babies are able to make other kinds of needed sugar from protein. However, untreated neonatal hypoglycemia can have devastating effects on some children, whose problematic hypoglycemia isn’t always clinically evident. The signs of neonatal hypoglycemia include a wide range of symptoms common in sick newborns and some babies exhibit no symptoms until they are seriously ill.

    Until now, there were no guidelines for physicians to use to determine when babies should be screened for neonatal hypoglycemia and when action should be taken to prevent brain damage.

    “The benefit of this approach is that it accounts for the infant’s overall metabolic and physiologic status and minimizes disruption of mother-child bonding and breast-feeding,” said Adamkin, chief, UofL Pediatrics-Neonatal Medicine.

    Neonatal hypoglycemia occurs most commonly in infants who are small for gestational age, those born between 34 and 37 weeks gestation and babies born to mothers with diabetes. Some experts believe infants who are large for gestational age are also at risk for neonatal hypoglycemia.

    The new guidelines provide a screening and feeding schedule based on all of these specific risk factors.

    Other clinically obvious conditions may place an infant at risk for neonatal hypoglycemia but because these conditions manifest themselves clinically they were not included in the guidelines.