Like a “spoonful of sugar,” this simple, non–invasive treatment keeps baby with Mom, promotes breastfeeding and saves health care costs.
Newborns with hypoglycemia, or low blood sugar, are becoming more common worldwide, a result of the growing number of mothers who are overweight, obese or diabetic. Breastfed newborns may be treated with supplementary formula feedings or, if that fails, with intravenous fluids, which requires mother and baby to be separated for hours or days at a time. Both processes interfere with mother–baby bonding and reduce the chances that exclusive breastfeeding will be established upon discharge from the hospital.

Now University at Buffalo researchers at Women & Children’s Hospital of Buffalo (WCHOB) and other teams worldwide are proving that a dose of dextrose gel administered into a baby’s cheek, as shown in this video, along with regular feedings can raise babies’ blood sugar, allowing them to stay with their mothers, which promotes breastfeeding. Because this method can eliminate the need for intravenous fluids, which have to be done in the Newborn Intensive Care Unit, it also saves health care costs.

“Birthing is stressful enough,” said Lakshminrusimha, a pediatric neonatologist with UBMD Pediatrics. "It’s further upsetting to a young mother, especially a first–time mother, if she is not able to breastfeed her baby because of low glucose so that the baby needs IV therapy.”

Dextrose gel was added to the existing hypoglycemia protocol for the newborn nurseries at two Buffalo area hospitals in 2014, an idea that came out of a journal club discussion facilitated by Lakshminrusimha and Munmun Rawat, MD, then a fellow in neonatology at UB, whom he was then mentoring, as well as colleagues at WCHOB and UB.

The UB researchers wanted to evaluate the safety and efficacy of oral dextrose therapy combined with feedings to reduce the need for IV dextrose therapy in babies born at or near–term and to evaluate how that therapy would influence feeding patterns for babies prior to discharge from the hospital.

The UB team published their results last fall in Karger Biomedicine Hub, describing how the use of dextrose gel in asymptomatic babies with low blood sugar helped reduce overall NICU admissions at WCHOB for hypoglycemia from 42 percent to 26 percent. In a majority of babies – 74 percent – the sugar gel successfully addressed low blood sugars versus only 58 percent of babies who received regular feedings alone, prior to implementation of the new protocol.

The results highlight a drawback of the use of feedings alone, according to Praveen Chandrasekharan, MD, research assistant professor of pediatrics at UB, attending neonatologist at WCHOB, pediatric neonatologist with UBMD Pediatrics and co–author on the paper.

“Dextrose gel is used in adult diabetics all the time,” he said, “while in babies, the protocol was to just do feedings. There is sugar in milk, but 100 milliliters of breastmilk or formula has only 7 grams of sugar, while 100 milliliters of gel has 40 grams of sugar.”

“We found that when we used the dextrose gel, we could significantly reduce admissions to the newborn intensive care unit, improve the level of breastfeeding at discharge and reduce health care costs,” he said. “Previously, if the baby didn’t get better after three feeds, they automatically were admitted to the NICU.”

When Chandrasekharan presented findings on this research last spring at the Pediatric Academic Societies meeting, the reaction was overwhelming.