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Updated: Nov 5, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Supplementation-based hypoglycemia guidelines including donor breast milk reduce NICU admission
Adharsh Ponnapakkam1,2, Donald Rees3, Maria Cristina Gallup4
1Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX, USA. adharsh.p.ponnapakkam.mil@mail.mil.
Objective:
To study the effects of a supplementation-based hypoglycemia guideline including donor (DM) on NICU admission, exclusive breastfeeding, and blood glucose concentrations in infants at-risk for neonatal hypoglycemia (NH).
Project Design:
We integrated DM, feeding supplementation, and reduced frequency of blood glucose testing into an NH bundle for term and late-preterm newborns. We then examined NICU admission rates and rates of exclusive breastfeeding at discharge.
Results:
NICU admission rates were reduced to 6% (-10%). Exclusive breastfeeding rates increased to 55% (+22%). Median cost of DM utilization was $13.73 per patient with an average volume of 50.8 ml/infant. DM supplementation resulted in similar times to last hypoglycemic episode and greater increases in blood glucose compared to expressed breast milk or breastfeeding alone (+9.6 mg/dL, p < 0.05).
Conclusions:
A supplementation-based hypoglycemia guideline including donor milk may be an effective way to reduce NICU admissions for asymptomatic hypoglycemia and support mothers in achieving breastfeeding goals.
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