If a newborn's blood glucose is less than 40 mg/dL, what is the recommended IV treatment?

• A. IV bolus of 10% dextrose solution
• B. Oral glucose gel
• C. IV bolus of 50% dextrose
• D. Preparation of 5% dextrose infusion

Answer: (A)

When a newborn’s glucose is below 40 mg/dL, the priority is to raise blood sugar quickly with an IV dextrose bolus. The recommended approach is to give 2 mL/kg of a 10% dextrose solution as an IV push. This delivers about 0.2 g of glucose per kilogram, providing a rapid correction to bring the level above the hypoglycemia threshold. After the bolus, start a maintenance IV dextrose infusion to keep glucose above 40 mg/dL.

Using a highly concentrated solution like 50% dextrose is too strong for a neonate and carries a risk of vein irritation and tissue injury; a 5% dextrose infusion alone would be too slow to correct the emergency. Oral glucose gel isn’t the preferred method when IV treatment is indicated because IV correction is faster and more reliable in a turning-point situation.