A large for gestational age baby delivered at 40 weeks was observed to be lethargic. The blood sugar was measured to be 35 mg/dl. The management is –

Symtomatic (Lethargy) Hypoglycemia (<10mg/d1) should be managed with 10% IV Dextrose. Treatment of neonatal hypoglycemia Asymptomatic with blood glucose between 20-40 mg/d1:- Direct breast feeding is started. If neonate is unable to suck, expressed breast milk is given. Expressed breast milk should be fortified by 5g sugar per 100 ml of milk Symptomatic or asymptomatic with blood glucose <20 mg/d1:- Bolus 10% dextrose 2m1/kg is given IV. Followed by continuous infusion of 6 mg/kg/minute. If nonnoglycemia is not achieved within 24 hours, glucocorticoids (prednisone or hydrocortisone) should be administered. For intractable hypoglycemia, glucagon, epinephrine or diazoxide can be given.