Glycemic status in exclusively breast fed low birth weight babies In first 72 hours of life in a teriary care hospital

Background: Neonatal hypoglycaemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. It can lead to considerable mortality and morbidity with long term neurological sequelae. Adequate breast feeding play an important role in maintaining normal glucose levels. So, this study is done to assess the incidence of hypoglycaemia in exclusively breast fed low birth weight babies, both term and preterm neonates and evaluate the impact of early breast feeding on glycaemic status upto 72 hours of life.Methods: This study was conducted over 12 month period involving 236 AGA (Appropriate for gestational age), SGA (Small for gestational age) babies with birth weight between 1.6-2.49 kg. Blood glucose values were measured at birth, 3h, 6h, 12h, 24h, 48h and 72h of life after delivery which was independent of feeding time. Hypoglycaemia was assessed against age of onset, gestational age, sex of baby, mode of delivery and time of initiation of breast feeding.Results: Total 56 episodes of hypoglycaemia were recorded in 52 babies of which 46 (27%) were term SGA babies and 6(8%) were preterm AGA babies (p=0.00148). The incidence of hypoglycaemia was found to be 22%, highest during the first 24 hours of life (93%) and delayed breast feeding is the most commonly noted risk factor (p=0.00024).Conclusions: Low birth babies are more prone to develop hypoglycaemia especially in first 24 hours of life with delayed introduction of breast feeding being one of the common risk factors and asymptomatic hypoglycaemia can be managed with frequent breast feeding without any formula feeds.