Could something so simple, and so affordable, help prevent newborn babies getting low blood sugar levels, a precursor to a high risk of brain damage?
New Zealand research led to the global practice of giving babies a $2 sugar gel, rubbed into the inside of their cheek, to improve their blood sugar levels. It reduced the likelihood of being admitted into Neo-natal Intensive Care Unit (NICU) for an intravenous drip, separating mum and baby during an important bonding time.
But could a sugar gel be used not only as a treatment, but also a preventative?
That is the question Auckland researcher and neonatologist at Auckland City Hospital, Dr Jane Alsweiler is trying to answer.
“With funding from the Auckland Medical Research Foundation (AMRF), we have been trialling giving dextrose gel at an hour of age to try to prevent babies’ blood sugar going low,” Jane explains.
“If your sugar goes too low for too long a period of time in that first 48 hours, it can cause permanent brain damage. Sugar is really important for the brain. That’s where it gets its energy from.”
Approximately a third of all babies are at risk of low blood sugar levels – especially those that are born to a mum with diabetes, or if they are born preterm/small for gestational age or born large for gestational age.
Newborn babies at risk were given a dose of sugar gel at one hour of age to try to stop their blood sugar from becoming low and then had their blood sugar tested at two hours of age. The trial found that sugar gel reduced the number of babies who had low blood sugar levels.
“We are now following up these children at two years of age to find out if the sugar gel improved their brain development,” Jane explains.
AMRF also funded the ongoing CHYLD Study, that aims to ascertain the long-term impact of mildly low blood sugars for short periods.
“We know that having really low sugars for a long period of time is bad for your brain. We’re not sure yet if having a mildly low blood sugar for a short period of time has long-term effects on the brain,” Jane says.
A follow-up study at age four and a half found that children who had had low blood sugar levels as babies were more likely to have poor executive function and visual/motor co-ordination.
“Both of which are important for doing well at school,” Jane says, “so now we’re assessing these children again at three to six years of age. The whole idea is to improve children’s long-term development.”
This extensive suite of research projects and clinical trials has been co-funded by the AMRF, through scholarships, fellowships and project grants, over many years, and Jane’s work has been regularly supported by the Foundation.
“The reason that I’m in academia is because the ARMF awarded me the prestigious Ruth Spencer Medical Research Fellowship in 2005, to undertake my PhD on high blood sugar levels in very preterm babies.
“I wouldn’t have been able to do my PhD and become a medical academic without that fellowship.” Sue Brewster, Chief Executive of AMRF, says research takes time, often discoveries lead to more questions and research requires financial support.
“The AMRF is proud to have been integral to years of research in this area, and our generous donors have played a fundamental part in enabling ground-breaking discoveries that are having such a positive impact on children’s lives and their grateful families.”
LIFE’S SWEET FOR BIG BOY ZACH
Throughout her pregnancy, Michelle O’Brien was often told to prepare for a big baby.
Her first child, Chloe, was born weighing 4.07kg, and indications were that her second baby could be even bigger.
This meant Michelle’s second baby met the criteria for Jane Alsweiler’s clinical trial – using dextrose gel as a preventative measure against hypoglycaemia (low blood sugar levels) – in newborns.
“It was explained to me that low blood sugars can cause brain damage and that treatment could include the baby needing to go into intensive care.
When Zach was born weighing 4.47kg, he qualified to be part of the trial, which I was really glad of.” A small amount of dextrose gel was rubbed into Zach’s gum shortly after he was born – even without leaving his mother’s arms.
“Those first few hours are so important for mums and babies for bonding, so it’s wonderful to be able to do something that might help to reduce the chance of us being separated. To think that there is a simple and painless treatment that could mean I had more time with my baby boy in those precious hours after birth is fantastic,” Michelle says.
“I am grateful we could be part of the trial. It’s a really nice feeling knowing that at such a young age he was helping to contribute to research that will help so many other mums and their babies in the future – that was really special to our family.”
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