What is the recommended bolus for symptomatic infants with hypoglycemia?

The recommended bolus for symptomatic infants with hypoglycemia is 2 mL/kg of D10. This choice is grounded in current clinical guidelines that emphasize the importance of rapidly correcting hypoglycemia in infants. D10, or 10% dextrose, is commonly used because it provides a quick source of glucose, which is essential for supporting the infant's metabolic needs and preventing neurological damage due to low blood sugar levels.

The selection of the bolus dose—2 mL/kg—strikes a balance between effectiveness and safety, ensuring that sufficient glucose is delivered without risking fluid overload or other potential complications. Hypoglycemia in infants can lead to serious outcomes, so timely and appropriate treatment with the correct concentration of dextrose is critical.

In contrast, other choices either provide an incorrect concentration of dextrose or involve the use of normal saline, which does not address the underlying issue of low blood sugar. Known guidelines focus on specific concentrations like D10 over D20 due to the importance of ensuring that glucose levels are raised efficiently and safely in this vulnerable population.