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

Ans. is `b' i.e., 10% IV Dextrose o Symtomatic (Lethargy) Hypoglycemia (<40mg/d1) should be managed with 10% IV Dextrose. Treatment of neonatal hypoglycemia (1) Asymptomatic with blood glucose between 20-40 mg/dl Direct breast feeding is staed. If neonate is unable to suck, expressed breast milk is given. Expressed breast milk should be foified by 5g sugar per 100 ml of milk. (2) Symptomatic or asymptomatic with blood glucose Bolus 10% dextrose 2m1/kg is given IV. Followed by continuous infusion of 6 mg/kg/minute. If normoglycemia is not achieved within 24 hours, glucocoicoids (prednisone or hydrocoisone) should he administered. For intractable hypoglycemia, glucagon, epinephrine or diazoxide can be given.