Your term baby may have been admitted to the neonatal unit because they were having problems in maintaining their blood sugar levels or due to vomiting when with you on the postnatal floor.

Low Blood Sugar

At birth, the level of sugar in the blood of a baby is similar to that of an adult’s level.  Within a short period of time, the baby’s blood sugar level drops quickly.  In a healthy term baby, exclusive breastfeeding generally meets their needs and this should be started within an hour after birth. Breastfeeding brings their sugar levels back to a normal range. If the baby cannot get their blood sugar levels back within the normal range, they have hypoglycaemia (or a low blood sugar level). Preterm babies are more prone to low blood sugar levels than term babies.

If your baby is suspected of having hypoglycaemia, they will be tested to confirm. This either involves taking blood from the heel (a heel prick) or intravenously (from their veins). Often, hypoglycaemia results from poor feeding. If this is the reason, your baby’s feeding regime will be changed. If your baby remains hypoglycaemic after 24 hours, further investigations will be required. 

Babies at risk of hypoglycaemia include:

  • small for gestational age babies
  • babies born prematurely; babies who are poor feeders
  • babies who have suffered intrapartum asphyxia, or oxygen deprivation
  • sick babies
  • babies of diabetic mothers
What are the treatments?

Persistent hypoglycaemia, i.e. lasting longer than 24 hours, is a cause for concern and further tests will be needed. Sometimes, the baby’s doctor will look for input from the endocrinology team.  In general, the treatment for hypoglycaemia is frequent feeding.  However, in the cases where the blood glucose remains low, or critically low, dextrose (a form of sugar) will be given intravenously.  If your baby is showing signs of hypoglycaemia, e.g., jitteriness, being unwell, apnoea, cyanosis (turning blue), or convulsions, they will receive intravenous dextrose immediately.   

Mother and Baby

Vomiting should not be confused with posseting - bringing up milk.

Vomiting

If your term baby has bile-stained vomit, it is treated as serious and possibly as a medical emergency. Your baby’s feeds will be withheld and your baby will be placed on an intravenous drip for fluids and nutrients. Your baby will be closely observed by the medical team and they may be sent for X-ray.  

In addition, they may be given a barium ‘meal’ during the X-ray which allows the radiologist to determine if there are any obstructions in your baby’s upper gut, i.e. in their food pipe, stomach, or small intestines. Your baby will not be discharged home until the vomiting has settled down and their records reviewed by a Consultant Neonatologist.

Blood can also be present in a baby’s vomit. If this appears immediately after birth, it may be maternal blood which they have swallowed during birth, and can be distinguished from fetal blood. Blood in a baby’s vomit can also be caused from stress ulceration. This is common in asphyxiated babies, i.e. babies that experienced oxygen deprivation.

Irrespective of the cause of vomiting, it must be remembered that vomiting can cause your baby to dehydrate very quickly and hence, it can be detrimental to their health. If you have concerns or questions, please talk to your baby’s nurse or doctor. Finally, vomiting should not be confused with posseting, which occurs after feeding and is the bringing back-up of milk.