Auckland mother Amanda Kamani knows too much sugar is unhealthy for her two young sons. But she was happy for a dab of sugar gel to be rubbed inside the mouths of both her sons an hour after birth, knowing it could help prevent thousands of babies from developing a common, potentially dangerous condition.
Kamani and her sons took part in a series of studies by a research team from the Department of Paediatrics and the Liggins Institute at the University of Auckland investigating whether a simple dab of inexpensive dextrose (sugar) gel, applied to at-risk newborns on their inside cheek an hour after birth, could prevent them from getting neonatal hypoglycaemia.
As many as a third of babies born in New Zealand are at risk of this condition, which involves a sustained dip in blood sugar levels following birth. Left untreated, it can cause developmental brain damage and lowered education outcomes later in life. At-risk babies are those born smaller or larger than usual, preterm babies and babies whose mothers have any form of diabetes – this last a growing group, with the rising incidence of gestational (pregnancy-related) diabetes.
Low blood sugar often requires babies to go into an intensive or special care unit, separating mother and baby just as they are trying to establish breastfeeding in the critical first days after birth. Currently, there is no established preventative, and many at-risk newborns are given formula, which can also disrupt breastfeeding.
Kamani is a nurse who has worked in a neonatal intensive care unit (NICU), and has type 1 diabetes. When she heard about the studies she leapt at the chance to participate.
“I was really keen,” she says. “This is an amazing trial because if it works it'll be so good – if you can give all babies at risk this sugar gel, and then most of them don’t have low blood sugar and everything that goes with that.”
Her firstborn son, Tobias, now aged three, took part in the preliminary trial, dubbed “pre-hPOD”, designed to find the best dose of sugar gel to use, and a follow-up study at age two. Her second son, six-months-old Xavier, took part in a larger main “hPOD” trial, still underway, comparing dextrose gel with placebo in newborn babies at risk of neonatal hypoglycaemia.
Kamani liked that the trial didn’t interfere with bonding in those early hours. “The gel was rubbed in his mouth and he stayed with me - I could still hold him and cuddle him. Then they tested his blood sugars – a prick on his heel - which they would have done anyway because he was at risk for low blood sugars.”
Findings from the pre-hPOD trial are published today in high-ranking journal PLOS Medicine.
Newborns in the trial were either given a single dose at one hour after birth, or that first dose plus three others within the first 12 hours. Researchers also tested smaller and larger first doses. A single smaller dose was the most effective and best-tolerated by babies and parents.