Implementation and outcomes of a standard dose dextrose gel protocol for management of transient neonatal hypoglycemia

Objective The use of oral dextrose gel (DG) reduces IV dextrose use. Prior studies used weight-based dosing (WD), though barriers exist, and are mitigated using standard dosing (SD). Our outcomes include IV dextrose use, NICU admissions, breastfeeding, adverse events, and assessment of WD vs SD. Study design Retrospective chart review comparing pre-DG, WD, and SD in 16490 newborns (1329 hypoglycemic) ≥ 35 weeks admitted to the nursery over 3 years. Results There was reduction in IV dextrose use 10.9% vs 6.5% ( p = 0.004) and NICU admissions 27.9% vs 16.1% ( p < 0.001) associated with DG use, and increased rate of breastfed infants 33.8% vs 43.5% ( p = 0.001), with no difference between WD and SD. No difference noted in adverse events across the study period. Conclusions DG utilization is associated with reduced IV dextrose use, NICU admissions, and improved breastfeeding rates without changes in adverse events. We offer SD as a safe alternative to WD.