Hypoglycemia

Brain cells require glucose to live and function.  A reduction in a newborn baby’s glucose (hypoglycemia) can, if significant enough, result in the brain cells dying and a resultant permanent brain injury.

During pregnancy the baby receives the necessary glucose from mom.  When the baby is delivered, the glucose supply from mom stops and the baby must produce his/her own glucose and relies in large part on its own glycogen reserves.  The newborn brain is proportionally larger in size (about 1/3 of total body size) than an adult and thus the newborn glycogen demand for appropriate brain cell functioning is proportionally higher.

Some babies are born with fewer glucose reserves.  Babies that are growth restricted or small for gestational age, have experienced a hypoxic ischemic episode (an inadequate supply of oxygen to the brain), are born preterm, or born to diabetic mothers are at increased risk.

In 2004 the Canadian Pediatric Society published guidelines on Screening for Newborns at Risk for Low Blood Glucose.  These guidelines identify babies at particular risk for hypoglycemia, identify the steps to be followed to monitor the newborn’s glucose levels and the recommended treatment for hypoglycemia.  The guidelines were reaffirmed in 2014.

Despite the existence of these guidelines, avoidable brain injuries still occur in newborns due to nurses and physicians failing to follow the recommended testing and treatment guidelines.

The issue of a possible hypoglycemic brain injury should be considered and investigated by legal counsel.  The brain imaging by MRI or CT will assist in determining if a brain injury did occur and, if so, whether hypoglycemia was involved.  If so, there should be a careful review of the clinical records to determine if the healthcare professionals followed the guidelines established by the Canadian Pediatric Society.