Parental Advocacy in the NICU: A Unique Case of Infant Hypoglycemia Highlighting the Role of the Family in Improving Outcomes.

Hypoglycemia, a common infant disorder caused by maternal antihypertensive medications, is a rare but serious complication. Increasing awareness of this potential side effect is crucial for all infant health care providers to facilitate early recognition and treatment, thereby mitigating risks of adverse infant outcomes. In this unique case, maternal metoprolol was prescribed for dysautonomia during pregnancy, which resulted in hypoglycemia in the infant. Born at 39 weeks' gestation, male infant presented with signs of hypoglycemia in the first 12 hours of life. After persistent prompting from the mother, a bedside glucose test was performed, with a "low" result. The infant received glucose gel and formula supplementation after breastfeeding, but persistent hypoglycemia necessitated a 4-day admission to the NICU. The diagnosis was hypoglycemia related to maternal prenatal metoprolol use. In addition to standard treatment for hypoglycemia, this infant's parents chose to cease breastfeeding to avoid potential adverse effects of hypoglycemia is understandable but should be of concern to all infant providers. Treatment of maternal hypertensive disorders utilizing beta-blocker medications during pregnancy is common. Increased awareness of hypoglycemia as a rare but potential complication can lead to early recognition by infant providers to reduce the risk of NICU admission.