Over-the-counter gel found to help hypoglycemic babies avoid brain damage

Sugar gel massaged inside baby's cheek can help avoid neurological condition linked to hypoglycaemia, Lancet reports

A small dollop of dextrose gel inside the mouth of a newborn baby with dangerously low blood sugar levels can prevent the child becoming brain damaged, new research shows.

Giving the gel will help the 5% to 15% of newborn babies born with hypoglycaemia avoid the serious neurological damage that the condition can cause, suggests a study in The Lancet medical journal.

Doctors and midwives last night hailed the results of the trial as a potentially significant breakthrough in the treatment of newborns with hypoglycaemia and urged the NHS to make it routinely available in hospitals.

The gel, which costs only about £1.25p per child, works better than the standard existing treatment of breastfeeding and regular blood tests, researchers found.

"Our study is the first report in babies showing that dextrose gel massaged into the inside of the cheek is more effective than feeding alone for treating hypoglycaemia, and is safe and simple to use," said Jane Harding, a professor at the University of Auckland, New Zealand, and leader of the study.

The gel could reduce the number of babies who have to spend time in a neonatal intensive care unit being treated with intravenous glucose. That would mean mothers could stay with their babies instead of being separated, which would in turn allow more time to establish breastfeeding, Harding said.

Growing numbers of babies are ending up in intensive care with hypoglycaemia because more are being born prematurely and more mothers are developing diabetes in pregnancy or are obese. Diabetes and obesity both raise the risk of low blood sugar in a baby. Dextrose gel is already used to reverse hypoglycaemia in people with diabetes.

Harding and her colleagues examined 514 babies born in Waikato women's hospital in New Zealand between 2008 and 2010. Of these, 242 (47%) became hypoglycaemic due to their mother having maternal diabetes, or their being born early or of low weight.

The team found that treatment with dextrose almost halved the risk of the usual treatment failing, and meant some of the babies did not need intensive care.

Neena Modi, professor and vice-president for science and research at the Royal College of Paediatrics and Child Health, said the "quite exciting" results should lead to "the ready availability of this highly effective treatment".

By aiding breastfeeding it was helping babies lower their risk of developing diabetes or eczema, Modi said.

Simon Weston, a doctor at Leeds general infirmary, said he already used the gel occasionally to raise a newborn's blood glucose levels.

Weston said: "Symptomatic hypoglycaemia is dangerous. When low glucose is associated with neurological symptoms, then restoration of good glucose control becomes urgent. If left, brain damage may occur.

"These results are good news for mothers who have have an increased risk of hypoglycaemia: mothers with diabetes, and those with small-for-gestational-age babies."

But getting the dose and administration of the gel correct was vital to avoid complications for the baby, he added.

Louise Silverton, deputy general secretary of the Royal College of Midwives, also welcomed the finding. The gel would be "less invasive treatment for babies who are usually admitted to intensive care for intravenous glucose", she said.

© Guardian News and Media 2013

[Image: "Friendly Mature Pediatrician Doctor Examining Newborn Baby In House" via Shutterstock]