What initial treatment should be provided if a newborn is found to be hypoglycemic?

In cases of newborn hypoglycemia, the most immediate and effective treatment is to administer an intravenous bolus of D10W (10% dextrose in water) or D5W (5% dextrose in water). This approach is favored because intravenous administration allows for rapid delivery of glucose directly into the bloodstream, which is crucial in treating hypoglycemia, especially in a newborn whose ability to metabolize and respond to glucose may be compromised.

Newborns are particularly vulnerable to the effects of low blood sugar due to their limited glycogen stores and ongoing metabolic demands. Severe hypoglycemia can lead to significant neurological damage, making prompt intervention essential. Using an intravenous bolus ensures that the newborn quickly receives an adequate dose of glucose, leading to a faster resolution of symptoms and helping to prevent potential complications.

While other options may have certain applications in different contexts, they are not the best initial treatments for a newborn experiencing hypoglycemia. Oral feeding may not be safe or effective if the newborn is unable to feed or if there is a risk of aspiration. Subcutaneous glucose injections are not typically used in this scenario, as intravenous administration is more immediate and effective. Monitoring until symptoms resolve can delay necessary intervention and potentially worsen the infant's condition.