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Perspective from the chairs of the British Association of Perinatal Medicine Framework for Practice working group on neonatal hypoglycaemia
  1. James P Boardman1,
  2. Janette Westman2
  1. 1MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
  2. 2Baby Friendly Initiative, Unicef, London, UK
  1. Correspondence to Professor James P Boardman, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh EH16 4TJ, UK; james.boardman{at}ed.ac.uk

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The purpose of the Framework for Practice (FfP) is to address variations in practice in identification, management and neonatal unit admission thresholds of term infants with hypoglycaemia and to promote safer practices that avoid unnecessary separation of mother and baby.1

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Two issues raise particular controversy:

Operational threshold for intervention in infants born at term without abnormal clinical signs.

The FfP recommends that clinicians should intervene to raise blood glucose (BG) concentration in infants with risk factors for impaired metabolic adaption but without abnormal clinical signs if BG concentration is <2.0 mmol/L on two occasions. This operational threshold was proposed by expert consensus in 2000,2 and no evidence-based modifications to it have been proposed despite review of the literature on several occasions since.3–6 The threshold is recommended in standard texts and is already used in some UK centres.

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