Crying baby

“I remember when I gave birth to my second little one, I had just gotten out of theater and the nursing staff were already on my case that her blood sugar was too low. I became very anxious because I did not want a single drop of formula to touch my little ones lips.” For a mother that is unaware of certain things, this statement can be very scary. This article tries to explain what is meant by a low blood sugar and how it can be prevented.

1.      What Is Low Blood Sugar?

Low blood sugar is also known as hypoglycemia. Hypoglycemia is a condition where an infant’s blood glucose levels drop beneath an acceptable level. Different hospitals and doctors will define hypoglycemia differently due to different tests used as well as how it is measured. A general guideline to see whether a baby has hypoglycemia or not is that the baby’s blood glucose level should not drop below 1.6 mmol/L on the 1st day of life and less than 2.2 mmol/L on day 2. This guideline is used in healthy term baby’s (40 weeks gestation) (1).

Low blood sugar


2.      What is a normal blood sugar level for a healthy new born baby?

Blood sugar levels are reported to decrease within the first two hours following birth. This is an adaptive phenomenon to help the baby to adapt to his/her new environment. Your baby now must become used to feeding at certain periods where he/she was used to being fed continuously while still in the womb (1). Blood sugar levels of a baby will also depend on:

  • Type of milk feed given (breast milk versus formula milk- infants that are breastfed are reported to have a lower blood glucose level than those that are formula fed)
  • How often your baby feeds (it is therefore important that you give your baby free access to the breast whenever he/she wants to feed).

breast milk made


3.      How Do I Know If My Baby Has Low Blood Sugar If I Don’t Have Blood Tests?

Clinically you would also be able to see that a baby has possible low blood sugar if (1,2):

  • Baby is jittery
  • Baby has exaggerated reflexes
  • Baby demonstrates a high-pitched cry
  • Baby has seizures
  • Baby is lethargic
  • Baby has rapid breathing
  • Presence of cold stress (baby has a low body temperature)
  • Is refusing to feed
  • Baby struggles to suck at the breast

Breastfeeding infant cue



4.      Which babies are at risk to have low blood sugar levels?

Hypoglycaemia is more prominent in (1):

  • Babies born to a mother with diabetes
  • Babies born after 40 weeks gestation
  • Babies with a birth weight of less than 2.5 kg
  • Babies with a birth weight of more than 4 kg
  • Babies born to mothers that needed a glucose drip, had a long labour or had high blood pressure during birth
  • Babies that experienced stress at birth

Exclusive Breastfeeding My Baby


5.      How does a low blood sugar affect my baby’s ability to breastfeed?

Hypoglycaemia affects breastfeeding in the following ways (1):

  • Baby can become fussy at the breast (this makes it harder to attach the baby to the breast which can further lower the blood glucose level)
  • Your baby can be very sleepy and difficult to wake (this decreases the amount of times your baby will drink from your breast)
  • Your baby might not get enough breast milk in
  • Substances other than breast milk is given (This can decrease your breast milk supply as you remove less breast milk from your breast- and remember the more you remove the more you will have)


6.      What can I do to make sure my baby’s sugar levels do not drop to low?

The take home message would be to make sure you and your baby are together during the day so that baby led breastfeeding as well as skin-to-skin can take place. Skin-to-skin also is an important aspect to consider. Skin to skin is also known as kangaroo mother care as a kangaroo will give birth and then place her baby (joey) in her pouch where her baby will stay till stable enough to be outside. Skin-to-skin is where a mother will place her baby on her chest. It is essential for the baby’s skin to be exposed as well as the mothers. A blanket can be put over the mother and baby once skin to skin contact is made. The baby then remains on the mother chest for as long as possible. The second aspect is that the mother should practice baby led feeding, where her baby can breastfeed as often as he/she wants (no time limit) (1,2).

Skin to skin



  1. Wambach, K. & Riodan, J.   Breastfeeding and human lactation.  5th ed.  United States of America:  James and Bartlett Learning.
  2. Wilson-Clay, B. & Hoover, K.L.   The breastfeeding atlas.  6th ed.  LactNews Press:  Texas.


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