A New Evidence Based Approach to Neonatal Hypoglycemia: Use of Oral Dextrose Gel

Mustafa Belli & Nevin Uslu^*

Mehmet Akif Ersoy University, Turkey

*Correspondence to: Dr. Nevin Uslu, Mehmet Akif Ersoy University, Turkey.

Copyright © 2018 Dr. Nevin Uslu, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Neonatal hypoglycemia is a common metabolic condition that occurs in the first 48 hours, affects 15% of newborns and may lead to brain damages. In order to prevent neonatal hypoglycemia, it is crucial that newborns are fed at an early period. Although oral feeding is mostly the first choice of treatment, intravenous dextrose treatment (IVDT) is also used. For IVDT, newborns are generally treated in intensive care units (ICUs). That newborns are cared in ICUs causes a negative mother-baby interaction, weaning, invasive interventions for newborns (measuring blood glucose, IV catheterization, etc.), neonatal stress and increased hospital costs. Therefore, it is important that newborns are enterally fed at an early period.

Recently, the number of randomized controlled studies in which use of oral dextrose gel and its efficacy are studied in relation to newborn enteral feeding has increased. It is reported that this practice is an easy and non-invasive method that reduces disengagement between mother and baby, encourages mothers to breastfeed, increases family satisfaction and decreases hospital costs. The studies undertaken recommend use of one dose 200mg/kg (0.5ml/kg) 40% dextrose gel on buccal mucosa by massaging in order to prevent and to treat hypoglycemia. It is emphasized that there are no adverse or rebound effects. However, there are no data as to what the specific threshold is or what specific blood glucoses level is in order to make interventions. Additionally, in literature, there is a need for more studies to study whether or not use of oral dextrose gel will decrease admissions in neonatal intensive care units and rate of neurodevelopmental disorders.

Use of oral dextrose gel produces positive effects in family-oriented and atraumatic care. Neonatal nurses should use oral dextrose gel in care and should conduct randomized controlled and evidence-based studies that investigate its effects upon neonatal health and care. Many hospitals should develop protocols as to use of oral dextrose gel.

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