Protecting your baby from getting a low blood sugar (Hypoglycaemia) 

Because your baby is at higher risk, regular blood sugar checks are advised during the first hours and days after birth.

The test:

• Uses a small blood sample taken from your baby’s heel
• Can usually be done while your baby is having skin-to-skin contact with you
• Gives a result straight away

The first test is usually done before the second feed, around 2 to 4 hours after birth.

Further tests may be needed until your baby’s blood sugar levels are stable.

You and your baby will usually need to stay in hospital while these checks are being carried out.

Have skin-to-skin contact

Holding your baby against your bare chest helps:

• Keep them warm
• Keep them calm
• Support breastfeeding
• Have healthy blood sugar levels

Make sure:

• Your baby’s face can be seen all the time
• Their airway is clear
• You are in a comfortable position with your head and shoulders raised

Keep your baby warm

When having skin-to-skin contact:

• Put a hat on your baby
• Cover them with a blanket or towel

When your baby is in a cot:

• Use blankets to keep them warm

After 24 hours, babies do not usually need to wear a hat indoors.

Feed your baby as soon as possible after birth

Ask your midwife or maternity staff for support with feeding until you feel confident.

Feed your baby regularly

Feed your baby:

• Whenever they show signs of hunger
• At least every 3 hours until blood sugar levels are stable

Early feeding cues include:

• Moving their eyes under closed eyelids
• Opening their mouth
• Sucking their hands or fingers
• Moving around more
• Making feeding sounds

Do not wait until your baby cries.

Expressing breast milk (colostrum)

If you are breastfeeding and your baby is finding feeding difficult:

• Try expressing your milk and giving it to your baby
• Ask staff to show you how to hand express
• You may also use a breast pump if needed

If you are pregnant, talk to your midwife about hand expressing.

Tell a member of staff straight away if you are worried about your baby.

Parents often notice changes before anyone else.

Your baby is not feeding well

In the first few days:

• Babies should feed at least every 3 hours until blood sugar levels are stable
• After that, they should feed at least 8 times in 24 hours

Seek advice if your baby becomes less interested in feeding.

Your baby is too cold or too hot

Your baby should feel slightly warm to touch.

A normal temperature is:  36.5°C to 37.5°C

A baby who is too cold or too hot may become unwell.

Your baby is difficult to wake

When awake, babies should:

• Look at you
• Respond to voices and touch
• Show normal movements

If your baby is very sleepy and difficult to wake, tell a healthcare professional.

Your baby seems floppy or has unusual movements

Seek urgent advice if your baby:

• Feels very floppy
• Has little or no muscle tone
• Has repeated strong jerking movements

Your baby’s colour changes

Your baby’s lips and tongue should look pink.

Seek help if they look pale, blue, or grey.

Your baby is having breathing problems

Seek urgent help if your baby:

• Breathes very fast for a long time
• Appears to struggle when breathing
• Has flaring nostrils
• Makes noises with each breath

In hospital

Speak to any member of the maternity or neonatal team.

At home

Contact:

• Your community midwifery office contact number, if you are wanting some advice
• NHS 111 for urgent advice
• Your nearest children’s A&E department if you are very concerned

Emergency

Call 999 if your baby appears seriously unwell.

If a blood test shows low blood sugar:

1. Your baby will be fed as soon as possible.
2. Skin-to-skin contact will be advised.

If breastfeeding is difficult:

• Staff may help you express breast milk
• Expressed milk can be given by syringe or cup

If there is not enough expressed milk available:

• Giving formula milk might be advised

Some babies may also receive:

• Dextrose gel, a sugar gel placed inside the cheek to help raise blood sugar levels

If blood sugar remains low, or your baby is too sleepy or unwell to feed, they may need care on the Neonatal Unit or Special Care Baby Unit.

Most babies improve within 24 to 48 hours and have no ongoing problems.

Most babies can go home after 24 hours if:

• Blood sugar levels are stable
• Feeding is going well
• There are no other concerns

Before leaving hospital, make sure you know:

• How to recognise that your baby is feeding well
• How many wet and dirty nappies to expect
• When to seek medical advice

Breastfeeding

• Aim for at least 8 feeds in 24 hours
• Most babies will feed more often than this
• You can usually feed responsively (when your baby wants to feed)

Bottle feeding

• Feed when your baby shows hunger cues
• Allow your baby to decide how much milk they want
• Do not force your baby to finish a bottle

Seek medical advice if:

• Your baby is feeding poorly
• Your baby seems unusually sleepy
• Your baby is difficult to wake
• Your baby feels too cold or too hot
• You are worried for any reason

You know your baby best. If something does not seem right, ask for help.