Hypoglykemische cerebrale schade bij gezonde aterme neonaten die uitsluitend borstvoeding krijgen

- Two healthy breast-fed term infants were admitted to the neonatal unit with symptomatic hypoglycaemia and seizures. In both patients, risk factors (i.e. hypothermia) and symptoms of hypoglycaemia went unrecognised until apnoea or seizures developed. Both patients required antiepileptic medication for neonatal seizures. One patient had isolated restricted growth in head circumference in the first year of life. Follow-up at 11 years showed cognitive impairment and epilepsy. The other patient had normal head circumference and mild global delay in neurological development at the age of 36 months. Severe symptomatic hypoglycaemia in healthy breast-fed term infants may cause severe brain damage. Early recognition of risk factors such as hypothermia lasting more than 3 hours is essential to preventing hypoglycaemia. The presence of risk factors warrants additional bottle-feeding to maintain sufficient intake until breastfeeding is adequately established. Any uncertainty regarding the symptoms of hypoglycaemia should be investigated promptly.

Ned Tijdschr Geneeskd. 2008;152:721-6