As a paediatrician Alex Wallace knew her baby son Sam's larger size at birth put him at risk of having low blood sugar levels - or hypoglycaemia - which, if left untreated, can lead to brain damage.

But having undergone an emergency caesarean Dr Wallace knew the importance of staying with her 3.7kg son to establish breastfeeding.

So when Waikato Hospital neonatal nurse Dr Deborah Harris asked if Sam could participate in a study where his low blood sugar levels would be treated with an inexpensive, easily-administered dextrose gel, she jumped at the chance.

It eliminated the need for intravenous fluids and formula feeding, meaning he could stay in a ward with her instead of going into the newborn intensive care unit.


Dr Wallace said being part of the Sugar Babies study allowed Sam a chance to begin life in a non-invasive way.

Now the happy, healthy 2-year-old is a living example of the New Zealand research - published yesterday in the international medical journal the Lancet - which is set to change the way newborns are cared for around the world.

"It's an immense opportunity to make a real difference to the care of newborn babies," said Dr Wallace.

"It's a way of keeping mums and babies together and as a mum that's incredibly important when you've just had a baby and particularly when it's a situation that might not have gone according to plan, which was the case for us."

The study was a collaboration between Auckland University's Liggins Institute and Waikato Hospital in Hamilton.

Professor Jane Harding of the University of Auckland said low blood sugar - or neonatal hypoglycaemia - was a common problem which affected up to 15 per cent of otherwise healthy babies and was a treatable cause of brain damage.

Professor Harding said that the study was the first report showing that dextrose gel massaged into the inside of the cheek was more effective than feeding for treating hypoglycaemia, and was safe and simple to use.

"Dextrose gel treatment costs roughly $2 per baby and could help reduce admissions to neonatal intensive care for treatment with intravenous glucose - not only reducing costs but importantly, keeping mothers and babies together to encourage breastfeeding."

Treatment for late pre-term and full-term babies involved extra feeding and repeated blood tests to measure blood sugar levels. However, many babies were admitted to intensive care and given intravenous glucose because their blood sugar remained low.

Ground breaking
Low blood sugar
* Neonatal hypoglycaemia affects 15 per cent of healthy babies.
* Can cause brain damage.
* Usually treated by formula feeding.
* If that fails babies are admitted to newborn intensive care.
* This makes breastfeeding hard to establish as babies are separated from mothers.

The study
* Between 2008 and 2010, 514 at-risk babies aged 35 weeks gestation or older from Waikato Hospital were enrolled in the first 48 hours after birth. The ``Sugar Babies'' included at-risk babies from pregnancies complicated by maternal diabetes, pre-term birth, and low and high birthweight.

* Of those, 242 (47 per cent) became hypoglycaemic and were randomly assigned to dextrose gel or placebo gel for up to six doses over two days.

* Treatment with dextrose almost halved treatment failure, compared with the placebo, with no adverse effects.