Neonates at high risk of hypoglycaemia: Is admission necessary?

Abstract

Aim To evaluate the practice of routine admission of infants at high risk of hypoglycaemia by determining the incidence of hypoglycaemia, factors that predict necessary admission and breastfeeding outcomes. Methods A retrospective cohort study of neonates admitted to a tertiary neonatal unit for high risk of hypoglycaemia. Clinical data, including blood glucose concentrations, body fat percentage and time to initiation of feeding, were collected for 122 infant–maternal dyads for a 3‐year period from April 2016 to May 2019. Descriptive statistical analysis and binary logistic regression analysis were undertaken. Results Hypoglycaemia developed in 39.3% of the neonates identified as high risk. Overall, 69 out of 122 admissions were potentially avoidable. Initial blood glucose was the most significant predictive factor for necessary admission with odds ratio of 3.26 (95% confidence interval (CI) 1.04–10.17) for an initial glucose of 1.6–2.0 and 27.05 (95% CI 5.06–144.42) for initial glucose ≤1.5. Exclusive breastfeeding rates at discharge were lower in admitted infants (59%) compared to the overall hospital rate (75.6%). Conclusions Neonates at high risk of hypoglycaemia should be monitored with their mothers as most infants needing admission are detected by initial blood glucose concentration. This would reduce infant–maternal separation and potentially improve breastfeeding rates.

Investigating short-stay admission to a neonatal intensive care unit as a risk factor for reduced breast feeding at discharge in infants ≥36 weeks’ gestation: a retrospective cohort study

“…26 Although a small study in a regional setting, findings from several other studies confirm an association between NICU admission and early weaning. [27][28][29] In contrast to our study, a large Australian cohort of all gestation admissions to NICU was compared with non-admitted, finding that on discharge the admitted infants were more likely to be fully breast feeding. 30 The difference may lie in the extended period of lactation support provided during a longer admission; this was not always available for our short-term NICU admission cohort.…”