Hypoglycemic Reaction (Infant/Toddler) 

Blood sugar is also called glucose. It's used as energy by the body. Sometimes blood sugar drops too low (hypoglycemia). This causes a hypoglycemic reaction. Symptoms of a hypoglycemic reaction in infants include:

  • Being irritable or jittery

  • Shaking (tremors)

  • A high-pitched cry

  • Feeding problems

  • Lack of energy (lethargy) or limpness

  • Skin has a blue color

  • Very fast breathing or heart rate

Symptoms of a hypoglycemic reaction in older children include:

  • Feeling hungry, nervous, or angry

  • Acting out

  • Nightmares or waking up crying out

  • Headache

  • Sweating

  • Feeling weak

  • Confusion

  • In severe cases, a child may have a seizure or faint (lose consciousness)

Low blood sugar may occur in healthy children who have not eaten for a while. Some children are more likely to have hypoglycemic reactions. These include children with a metabolic or digestive problem, a hormone deficiency, or diabetes. Taking diabetes medicine or alcohol by accident may also cause low blood sugar.

This condition is diagnosed in children by testing blood. Low blood sugar must be raised to prevent a serious problem. First try raising your child’s blood sugar by giving a food or drink that is high in sugar. If that doesn't work, your child may be given an IV (intravenous) sugar solution. Or he or she may get a shot (injection) of glucagon. This is a medicine that helps raise blood sugar levels. A baby's blood may be tested again after he or she skips 1 or 2 feedings. For older children, blood may be tested again after not eating overnight. This is called a fasting test. If your child still has low blood sugar, the healthcare provider will test for other causes.

Home care

If your child has diabetes, the healthcare provider will prescribe medicine to control blood sugar levels. Follow instructions for giving this medicine.

General care

  • Know your child’s signs of hunger and low blood sugar. Hypoglycemic reactions most often occur before meals.

  • Make sure your child has small, frequent meals. If he or she is not eating well, talk with your child’s provider.

  • If your child has diabetes, limit hard physical activity until the diabetes is under control.

  • If you have diabetes and are breastfeeding your baby, watch your glucose levels closely.

  • If you are instructed to check your baby’s blood sugar, do so as directed.

If hypoglycemia symptoms return

At the first sign of low blood sugar, give your child a food or drink high in glucose. Make sure your child can eat and drink safely. Depending on your child's age, high-glucose options include:

  • For babies. Give formula or breastmilk. If your baby can't swallow, glucagon injections or IV glucose may be needed.

  • For toddlers. Try 4 ounces of fruit juice.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. If lab tests were done, call the provider for results as instructed.

When to get medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever higher than 100.4°F (38°C), or a temperature lower than what is normal for your child

  • Low blood sugar symptoms come back (see symptoms above)

Call 911

Call 911 if your child is:

  • Having a seizure

  • Not able to wake up

  • Not able to eat or drink safely

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