The investigation and management of neonatal hypoglycaemia

Assessment of neonatal glycaemic status requires accurate and reliable measurement of blood glucose concentrations. Most point-of-care technologies are, however, unsuitable for use in neonates. Although the definition of hypoglycaemia remains elusive, current knowledge allows adoption of pragmatic threshold blood glucose concentrations when clinical intervention should be considered. The vast majority of instances of neonatal hypoglycaemia are due to problems with the normal processes of metabolic adaptation after birth, and strategies to enhance the normal adaptive processes should help prevent such episodes. Further investigations and specific interventions should be considered when hypoglycaemia is of unusual severity or occurs in an otherwise low-risk infant.