The $2 treatment saving babies around the world

Kiwi ingenuity behind sweet spot in preventing neurological damage.

For generations women have opted to let their newborn undergo a heel prick test, potentially not fully understanding the importance of identifying their child’s blood sugar level. This simple procedure is the precursor to a similarly simple treatment that could ultimately prevent neurological issues, before their child is even two days old.

“Glucose, or sugar, is the primary fuel for your brain. If we get a low blood sugar we will get a bit woozy, we know to eat something. Babies cannot communicate that,” New Zealand’s first Neonatal Nurse Practitioner, Deborah Harris explains.

“And there is a link between low blood sugars soon after birth and poor neurological outcome. Put simply, brain damage.”

It was Harris’ Doctoral thesis that spurred a simple yet transformational way babies around the world are treated: oral dextrose gel. The gel treats low blood sugar – hypoglycaemia – in a similar way to people with diabetes, although it hadn’t been used on hypoglycaemic babies.

“About a third of all those babies in New Zealand are born at risk of low blood sugar – babies that are infants of diabetic mothers, or are small or large (either grown very well or not well at all while mum is pregnant), or are late pre-term [born after 35 weeks and before 40 weeks],” Harris says.

Babies with low blood sugars are normally treated with feeding. If that doesn’t improve blood sugars, admission to the newborn intensive care unit (NICU) is usually required, for treatment with intravenous dextrose, with a drip placed in the newborn’s hand.

“Most of these babies are otherwise healthy and it’s hard for a mother and baby to be separated so soon after birth.

“Our Sugar Babies Study research found babies with low blood sugars who were treated with dextrose gel showed improved blood sugar levels, were less likely to be admitted to the NICU for treatment and more likely to continue to be breast-fed,” Harris says. “And with oral dextrose gel, you treat the baby at the bedside.”

Safe, tolerated and inexpensive, 40% dextrose gel costs approximately $2 per baby, the gel is massaged into the inside of a baby’s cheek, and absorbed almost immediately. In the majority of babies one dose regulates their blood sugar levels while they are learning to get fuel from their milk.

Harris is “humbled” that her work has been so transformational, and says the hardest part of her job is finding research funding.

Supervised, and challenged by the “really clever” Distinguished Professor Dr Jane Harding at Auckland University, Harris’ work was funded in part by

two of New Zealand’s eight Medical Research Foundations – the Auckland Medical Research Foundation and Waikato Medical Research Foundation.

“I couldn’t have done the Sugar Babies study without the research foundations. The level of investment required can be significant. It gave me such a boost and allowed me to develop a treatment that is potentially life-changing.

“I feel like the little red engine, ‘I think I can, I think I can, oh I can’. Research is so important and fundamental to finding better ways to care for our people. Otherwise we keep doing the same things over and over and don’t advance our knowledge.

“I would love to have the money to try to find a better way to test blood glucose concentrations. The heel prick test is reasonably difficult to do well, and can cause distress for both the baby and parents.

“We can put men on the moon, we can do all sorts of very clever things but we cannot measure blood glucose levels easily in babies.”

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