Clinical Impact of Neonatal Hypoglycemia Screening in the Well-Baby Care

OBJECTIVES: To determine the proportion of well-appearing newborns screened for hypoglycemia; yield of specific screening criteria; and impact of screening on breastfeeding. STUDY DESIGN: Retrospective study of well-appearing at-risk infants born ≥36 weeks’ gestation with blood glucose measurements obtained ≤72 hours of age. RESULTS: Of 10,533 eligible well newborns, 48.7% were screened for hypoglycemia. Among tested infants, blood glucose <50 mg/dL occurred in 43% and 4.6% required intensive care for hypoglycemia. Blood glucose <50 mg/dL was associated with lower rates of exclusive breastfeeding (22% versus 65%, p <0.001). Infants screened due to late preterm birth were most frequently identified as hypoglycemic; the fewest abnormal values occurred among appropriate-weight, late term infants of non-diabetic mothers. CONCLUSION: Hypoglycemia risk criteria result in screening a large proportion of otherwise well newborns and negatively impact rates of exclusive breastfeeding. The risks and benefits of hypoglycemia screening recommendations should be urgently addressed.