Introduction Delayed treatment of hypoglycaemia can result in neurological sequelae, and death in babies. Over a decade, 79 claims have resulted in payouts of £300,000 to £7 million¹. A retrospective study of the incidence and management of neonatal hypoglycaemia was performed in July 2012.

Method The postnatal records of all mothers delivering neonates at risk of hypoglycaemia in July 2012 were screened. The temperature record, whether skin to skin care and early feeding was offered were studied. In addition monitoring of blood sugars and thresholds for admission to the neonatal unit were audited.

Results A total of 81 babies (n = 413) were identified as at risk for hypoglycaemia. 11% missed out on blood sugar monitoring completely. 38% had a blood sugar less than 2.6 at some point during their monitoring. 42% had a temperature less than 36.5C. 86% had skin to skin care and 89% were offered a feed within the first hour. 7.4% were admitted to the neonatal unit for further management. 66% of neonates admitted failed to comply with guidelines for review and admission to the neonatal unit. A prospective survey of relevant personnel identified lack of familiarity with guidelines resulting in delayed review and treatment. Risk to the baby was well recognised.

Conclusion This study identifies that despite high rates of early feeding and skin to skin care a significant proportion of at risk neonates develop neonatal hypoglycaemia. A substantial number need admission to the neonatal unit and often fail to comply with the standards for review and intervention despite guidelines.