Sugar Babies

This randomised controlled trial, completed in 2010, investigated the use of oral dextrose gel to treat neonatal hypoglycaemia (low blood glucose concentrations) in at-risk babies in their first 48 hours after birth.

Hypoglycaemia is the commonest metabolic disorder of the newborn, and the only known common preventable cause of brain damage in newborn babies. Up to 15% of newborn babies will have low blood glucose concentrations, and the rate is much higher in babies who have additional risk factors: up to 50% in babies of diabetic mothers and 66% in preterm babies.

Neonatal hypoglycaemia can cause brain damage and death, and its treatment commonly requires admission to the newborn intensive care unit or special care baby unit (NICU/SCBU), separating mothers and babies and interfering with the establishment of breast-feeding, thus incurring high social and financial cost.

In the Sugar Babies trial, we found that dextrose (sugar) gel was very effective at reversing hypoglycaemia, and also reduced the need for admission to neonatal intensive care for hypoglycaemia, and reduced the chance of the baby being formula fed at two weeks of age.

We also found that approximately half of babies at risk actually became hypoglycaemic, with no evidence to support different screening guidelines in different groups at risk.

Many of the children who took part in the Sugar Babies trial were seen again at two years of age as part of the CHYLD (Children with Hypoglycaemia and their Later Development) Study.

The success of the Sugar Babies trial led on to our current, multi-centre hPOD (hypoglycaemia Prevention with Oral Dextrose) Study, which is investigating whether giving a dextrose (sugar) gel to at-risk babies can stop their blood sugars going too low, therefore avoid the need to go to a Special Care Baby Unit and making it easier for mothers to breastfeed.

Key publications

Harris DL, Weston PJ, Signal M, Chase JG, Harding JE. Dextrose gel for treating neonatal hypoglycaemia: A randomized placebo-controlled trial (The Sugar Babies Study). Lancet 382: 2077-83, 2013. http://dx.doi.org/10.1016/S0140-6736(13)61645-1.
Accompanying commentary Lancet 382: 2045-2046, 2013.

Harris DL, Weston PJ, Harding JE. Incidence of neonatal hypoglycemia in babies identified as at risk. Journal of Pediatrics 161: 787-791, 2012. Accompanied by editorial pages 775-6.

Harris DL, Weston PJ, Harding JE. Mothers of babies enrolled in a randomized trial immediately after birth report a positive experience. Journal of Perinatology 2014 Jan 30, doi: 10.1038/jp.2013.183.

Weston PJ, Harris D, Battin M, Brown J, Hegarty J, Harding JE. Oral dextrose gel for the treatment of hypoglycaemia in newborn infants (Protocol). Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No.: CD011027. DOI: 10.1002/14651858.CD011027.