In particular, children at risk of neonatal hypoglycaemia should have their blood glucose monitored within one hour of birth. Management
Some infants are treated with 40% dextrose (a form of sugar) gel applied directly to the infants mouth. There are two main ways that neonatal hypoglycemia is treated. The first way includes intravenous infusion of glucose. For less severe, borderline, asymptomatic hypoglycemic neonates early introduction of breast milk can be effective for raising glucose levels to a healthy level. Any infant at risk of hypoglycemia should have their blood sugar taken again one hour after birth. Oral glucose is another option to restore normal glucose levels if the newborn is having difficulty latching to the breast or breastfeeding is not an option, however, breast milk is proven to be a better source as it includes glucose and carbohydrates. It is recommended by The American Academy of Pediatrics that infants feed within the first hour of life with the glucose reading being 30 minutes after this feeding for an accurate result. If the initial feeding does not raise the newborns blood glucose above 40 mg/dL then the newborn must receive an IV infusion of 10% dextrose in water as a mini bolus as 2 mL/kg over 1 minute. Following the mini bolus a continuous infusion of 10% dextrose in water at 80-100 mL/kg/day in order to maintain a healthy serum glucose level between 40 and 50 mg/dL. Maintaining newborn thermoregulation is a large part in preventing further hypoglycemia as well.
Bedside glucose monitoring is only effective if the equipment is accurate, rapid, and reliable. This form of testing is often faster and more cost effective. Laboratory serum glucose testing is the most accurate way of testing blood glucose levels. These specimens are either taken from the heel, arterial, or venous punctures and must be store immediately on ice in order to prevent glycolysis, further altering the results. USA guidelines recommended that the hypoglycemic neonate should have a glucose test every 2–4 hours for the first 24 hours of life. Guidelines in the UK, however, recommend pre-feed screening of at-risk infants at 2–4 hours of age (to avoid false positives when blood glucose is, ordinarily, at its lowest at 2–3 hours of age) and at the subsequent feed until a blood glucose level of  >2.0 mmol/L (36 mg/dL) on at least two consecutive occasions and is feeding well. 1. Medical history
Maternal diabetes mellitus, gestational hypertension, neonatal erythrocytosis, neonatal haemolysis of incompatible blood groups, perinatal asphyxia, severe infection, sclerosis, neonatal respiratory distress syndrome, etc., especially in premature babies, babies younger than gestational age and those who are underfed in the early stages of life are at risk of neonatal hypoglycaemia. 2. Clinical manifestations
Neonatal hypoglycemia should be considered if there are atypical clinical manifestations, if the symptoms improve after glucose infusion, or if there are neurological symptoms and signs that cannot be easily explained. 3. Blood glucose measurement
Postnatal glucose monitoring is the main method of early detection of neonatal hypoglycaemia.