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Written on 2nd July 2020 by Susan Brown

Hypoglycaemia means low blood sugar or low blood glucose. When a newborn baby’s blood sugar drops below safe levels, this is known as neonatal hypoglycaemia. Newborn babies can take a while to develop a regular feeding pattern, which means that some babies need help to keep their blood glucose levels up in the first few days of life.

Neonatal hypoglycaemia is common, but becomes dangerous if it is untreated, causing permanent brain damage and disability. If a baby suffers neurological disability as a result of incorrect treatment of hypoglycaemia, they may be entitled to claim compensation.

Who is at risk of neonatal hypoglycaemia?

Until they are feeding properly, all newborn babies are at some risk of hypoglycaemia. For this reason, it is part of the post-natal midwives’ job to ensure that the baby is receiving enough milk. The baby’s blood sugar is measured by a heel-prick blood test and is carried out routinely in some hospitals. This test should always be carried out for babies who are known to be at increased risk.

Babies have a higher risk of hypoglycaemia when:

  • They weigh less than 2.5kg  at birth.  This is the standard threshold level. Any baby with a birthweight of less than 2.5kg must have their blood glucose monitored.
  • Their mother has diabetes.
  • They are small for dates or have intra-uterine growth restriction (IUGR).

Regardless of birthweight or their mother’s state of health, any baby who is not feeding properly may be at risk, such as:

  • if they don’t wake up for feeds;
  • if they don’t suck properly during feeding;
  • if they demand feeding very frequently because they are not getting enough food at each feed.

Is neonatal hypoglycaemia a medical emergency?

Neonatal low blood sugar can be corrected if action is taken quickly to feed the baby. Depending on how well the baby feeds, their blood sugar may be brought back up by breastfeeding if that provides enough milk, by expressed breastmilk or formula milk. Some babies’ hypoglycaemia may need to be corrected by an intravenous (IV) glucose drip.

In a review of medical negligence claims relating to neonatal hypoglycaemia, the NHS defence organisation, NHS Resolution, found that abnormal feeding behaviour was very closely associated with the condition, both as a cause and as a result of hypoglycaemia. Maternal concerns about their babies’ abnormal feeding behaviour were often ignored by health professionals, missing a vital opportunity to take action to prevent hypoglycaemia before permanent damage was done to the infant’s brain.

If neonatal hypoglycaemia is severe or is left untreated, the baby’s condition will deteriorate, demonstrating other signs of illness. Neonatal hypoglycaemia with abnormal clinical signs must be treated as a medical emergency requiring immediate action to avoid permanent brain damage and severe neurodevelopmental disability. Abnormal signs which are commonly seen with hypoglycaemia include:

  • Hypothermia (low body temperature)
  • Floppiness
  • Fitting or jitteriness
  • Infection
  • Respiratory (breathing) difficulties

Hypoglycaemia can also occur alongside and in combination with other serious conditions.

My baby has brain damage from hypoglycaemia – do I have a claim?

NHS Resolution reviewed 25 neonatal hypoglycaemia claims which succeeded against the NHS over a ten-year period at a total cost of over £162 million. They identified the most common errors in hypoglycaemia care as:

  • delays in obtaining blood glucose test results;
  • delays in taking action on a low blood glucose result;
  • delays in referring babies to the paediatrician once concerns have been identified;
  • delays in admitting babies who have been diagnosed with significant hypoglycaemia to the neonatal unit (NNU);
  • delayed administration of IV glucose on the NNU;
  • giving insufficient glucose to correct the hypoglycaemia;
  • delayed attendance by the paediatrician when called by the midwife to review;
  • failing to advise the mother properly when the baby is discharged home.

Unlike disability from birth injury caused by lack of oxygen (hypoxia or asphyxia), neurodevelopmental disability from neonatal hypoglycaemia might not be obvious to the parents in the infant’s early childhood.  Neurodevelopmental disability from hypoglycaemia might be disregarded or downplayed until the child grows and the impact of their injury later becomes evident when they struggle to cope at school.

In its review, NHS Resolution accepted that it was likely that there have been more babies harmed by errors in hypoglycaemia care than were reported by the hospitals.  

Boyes Turner’s specialist brain injury solicitors understand hypoglycaemia negligence and are experienced in obtaining compensation for children and teenagers whose neurological disability was caused by incorrect neonatal care.

We aim for early admissions of liability. We then work with experts to assess the full impact of the injury on the individual’s mobility, intellect, education, work and independence, to ensure that our client is properly compensated. Our special educational needs (SEN) team can also help families secure educational support and the best school placements for with children affected by neonatal brain injury.   

If you are caring for a child who has suffered neurodevelopmental disability from negligent medical care, contact us by email