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NICU guideline identifier

Large or small for gestational age - management of infants on the postnatal ward

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See also Guideline on Management of Hypoglycaemia

This guideline refers to term or near-term babies who are:

These babies are at risk of:

  • hypoglycaemia
  • hypothermia
  • jaundice secondary to polycythaemia
  1. Temperature should be monitored before feeds for 12 hours or until stable
  2. Baby should be closely observed for signs of hypoglycaemia or hypothermia (e.g jitteriness, pallor, lethargy).
  3. Routine blood glucose measurement should have been requested by the LMC or Paediatrician within the first hour following birth and 4-hourly or pre-feed thereafter (whichever comes first). All blood glucose measurements should be performed by the Laboratory. That is, bedside testing methods (BM-stix, Precision-G monitors) are not reliable at detecting hypoglycaemia.
  4. Feeding should be commenced early; first feed within one hour of delivery and thereafter at least 3 hourly. Either breast or formula feeds (maternal preference) can be given. Complement feeds are not necessary unless the baby's blood glucose falls to <2.6mmol/L.
  5. The baby should be watched for jaundice and bilirubin levels measured as indicated.

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Document Control

  • Date last published: 29 July 2004
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years