Question

A term neonate has a blood glucose of 36 mg/dL. The infant is feeding well and has no clinical signs. Which characteristic of this neonate favours continued breastfeeding (with monitoring) rather than immediate intravenous dextrose infusion?

• A. The neonate is asymptomatic
• B. The neonate is symptomatic with jitteriness
• C. The neonate is having seizures
• D. The neonate is lethargic and not feeding

Hint:

No symptoms and feeding well? Feed and recheck rather than reach for the IV.

Answer 1

The Correct Option is A

When a newborn's sugar dips, the first question is always: is the baby symptomatic? That single answer steers the treatment.

A baby who is jittery, floppy, fitting, or refusing feeds is symptomatic and needs glucose into the vein straight away - a small $2\,\text{mL/kg}$ bolus of $10\%$ dextrose, then a maintenance infusion.

This particular term baby reads $36\,\text{mg/dL}$ yet looks completely well and is breastfeeding happily. Being $\textit{asymptomatic}$ is exactly what permits the gentler path: keep breastfeeding, then recheck the glucose, escalating to IV dextrose only if the level stays low or symptoms appear.

\[\boxed{\text{Asymptomatic} \Rightarrow \text{breastfeed and recheck rather than IV dextrose}}\]