title: Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia.
abstract: BACKGROUND
  Newborn infants with risk factors may require intravenous (IV) dextrose for asymptomatic hypoglycemia. Administration of IV dextrose and transfer to the neonatal intensive care unit (NICU) may interfere with parent-infant bonding.
  
  
  OBJECTIVE
  To study the effect of implementing dextrose gel supplement with feeds in late preterm/term infants affected by asymptomatic hypoglycemia on reducing IV dextrose therapy.
  
  
  METHODS
  A retrospective study was conducted before and after dextrose gel use: 05/01/2014 to 10/31/2014 and 11/01/2014 to 04/30/2015, respectively. Asymptomatic hypoglycemic (blood glucose level <45 mg/dl) infants in the newborn nursery (NBN) were given a maximum of 3 doses of dextrose gel (200 mg/kg of 40% dextrose) along with feeds. Transfer to the NICU for IV dextrose was considered treatment failure.
  
  
  RESULTS
  Dextrose gel with feeds increased the blood glucose level in 184/250 (74%) of asymptomatic hypoglycemic infants compared to 144/248 (58%) with feeds only (p < 0.01). Transfer from the NBN to the NICU for IV dextrose decreased from 35/1,000 to 25/1,000 live births (p < 0.01). Exclusive breastfeeding improved from 19 to 28% (p = 0.03).
  
  
  CONCLUSIONS
  Use of dextrose gel with feeds reduced the need for IV fluids, avoided separation from the mother and promoted breastfeeding. Neonates who failed dextrose gel therapy were more likely to be large for gestational age, delivered by cesarean section and had lower baseline blood glucose levels.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Munmun
authors.initials: M
authors.lastname: Rawat
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Praveen
authors.initials: P
authors.lastname: Chandrasekharan
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Turkovich
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Barclay
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Perry
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Schroeder
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Testa
authors.affiliation: Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
authors.forename: Satyan
authors.initials: S
authors.lastname: Lakshminrusimha
keywords: Dextrose gel; Hypoglycemia