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Breastfeeding and Its Impact on Glucose Trends and Hypoglycaemia Risk in At-Risk Neonates: A Prospective

Daniel Chan1,2,3, Suresh Chandran2,3,4, Mei Chien Chua2,3,4

  • 1Endocrinology Service, KK Women's and Children's Hospital, Singapore, Singapore.

Journal of Paediatrics and Child Health
|September 4, 2025
PubMed

Insights

Neonatal hypoglycemia risk was similar for breastfed and formula-fed infants, despite lower glucose levels in breastfed babies. These findings support prioritizing breastfeeding for at-risk newborns.

Area of Science:

  • Neonatal physiology
  • Pediatric nutrition
  • Endocrinology

Background:

  • Neonatal glucose regulation rapidly transitions post-birth, with at-risk infants facing hypoglycemia.
  • Early feeding is crucial, but the impact of feeding type on glucose homeostasis is unclear.

Purpose of the Study:

  • To compare glucose trajectories and hypoglycemia incidence between exclusively breastfed and formula-fed at-risk neonates.

Main Methods:

  • Prospective observational cohort study of 192 at-risk neonates.
  • Blood glucose measured at 2, 6, 12, 18, and 24 hours of life.
  • Hypoglycemia defined as <3.0 mmol/L; logistic regression used to assess risk.

Main Results:

  • Formula-fed neonates had higher glucose levels at 6, 12, and 24 hours (p<0.05).
  • Cumulative glucose exposure (AUC) was greater in formula-fed infants (85.1 vs. 80.5 mmol/L-hour).
  • Overall hypoglycemia incidence (<3.0 mmol/L) was similar between groups (14.7% vs. 11.1%, p=0.615).

Conclusions:

  • Breastfed neonates had lower glucose levels but comparable hypoglycemia risk to formula-fed neonates.
  • Findings support prioritizing breastfeeding for at-risk newborns.
  • Further research on long-term metabolic outcomes of feeding practices is warranted.
Abstract

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