We are in the process of revising our policy regarding monitoring of those newborns at risk for hypoglycemia i.e.- LGA, IDM,IUGR, SGA, post dates, near term, etc. Trying to get a feel for policies at other hospitals.

We screen the following groups of "high-risk" infants, cared for in the maternity:

- infants to diabetic mothers

- near-term infants (35-36 week)

- LGA

- SGA

- infants Apgar<4 at 5 min's, metabolic acidosis BE<-15 in cord blood or hypothermic postpartum

B-glucose are checked twice the first 24 hours. If supplementary feeding is started (generally done in the first four groups above), we check b-glucose after the 2nd and the 4th feeds.

This is the outlined management in our units depending on b-glucose levels (mmol/L)

>2.6 - unchanged strategy and no further controls

1.8-2.6 - increased feeding

<1.8 - consider iv glucose infusion

< 1.1 - NICU admission, glucose bolus and infusion

risks groups are quite the same along with others having signs and symptoms kindly inform tha since we do nt have pharmacy or comercially availabla solutions between 10./. and 25./.dextrose, we make dilutions from 25./. dextrose when reqrmnts abv 8mg/kg also because we arent familiar wth central lines plz guide