THIS IS PFD FOR BASIC KNOWLEDGE MS WORD.

1. SCHOOL OF NURSING AND
PARAMEDICAL SCIENCES

2. INFANTS OF
DIABETIC MOTHER
-SRIKESHVAR KUMAR MAURYA
-B.Sc Nursing (4th Year)
O.I.N.S.R, DAMOH (M.P)

3. CONTENTS
• INTRODUCTION
• DEFINITION
• TYPES
• CLINICAL FEATURES
• DIAGNOSTIC EVALUATION
• COMPLICATIONS
• MANAGEMENT
• PREVENTION
• NURSING MANAGEMENT

4. INTRODUCTION
Diabetes is a chronic disorder of metabolism
characterized by a partial or complete deficiency
of the hormone insulin. It is the most common
metabolic disease. Diabetes mellitus affect
approximately 15.7 million persons in the United
States. DM in children can occur at any age but
has a peak incidence between ages 10 and 15
years, with 75% diagnosed before 18 years of
age. The incidence in boys is slightly higher than
in girls. Maternal diabetes mellitus leads various
health problems in infants.

5. DEFINITION
It is defined as a baby who is born to a
mother with diabetes that causes baby
at risk of problems.

6. TYPES
1. Gestational Diabetes Mellitus – Mother who are
detected diabetes mellitus first time during the
present pregnancy.
2. Pre-existing (pre-pregnant) Diabetes Mellitus
– Mothers who have diabetes approximately mellitus
before pregnancy or conceiving.

7. INCIDENCE
It is estimated that childhood diabetes accounts
for around 5% of total population of diabetes. In
India there are about 4,00,000 infants and
children with this disease.

8. CLINICAL FEATURES or EFFECTS
OF DIABETES MELLITUS
 The infant of a diabetic mother is larger and
heavy (macrosomia).
 Body of neonates covered with vernix caseosa.
 Neonates may develop hypoglycemia if mother is
having severe hypoglycemia, sometimes it is
required to provide glucose by intravenously.
 Birth injury can occur due to large size of baby
during passage of fetus from birth canal.

9. DIAGNOSTIC EVALUATION
1. Before baby is born
A. Ultrasound :- It is done to detect the size of baby. It would
show Macrosomia.
B. Lung maturity test :- In this take sample of amniotic fluid
to detect lung surfactant ratio.
2. After Birth
A. Check Baby’s blood sugar level :- It check within first hour
or two hours after birth & rechecked regularly until it is
consistently normal.
This test would show hypoglycemia.
B. Check bilirubin level :- This test would show increased
bilirubin level (>5 mg/dl).
Normal bilirubin level in infant is below 5mg/dl.

10. C. Check the baby for sign of trouble with heart &
lungs
D. Echocardiogram :- It is a imaging test done to
check the size of baby’s heart.
Contd…

11. COMPLICATIONS
• Respiratory distress syndrome
• Hypocalcemia & Hyperbilirubinemia
• Congenital Malformation of brain,
gastrointestinal, urinary system and spinal cord
can occur.
• Pulmonary hypertension & polycythemia can
occur
• Birth asphyxia may occur.

12. MANAGEMENT
• Treatment of birth injury as early as possible.
• Oxygen supply to neonates if respiratory distress
occur.
• Provide glucose to prevent hypoglycemia.
• Continue monitoring of blood glucose level by a
umbilical catheter or by a needle.
• Start oral feeding as early as possible.
• Continue close monitoring of baby and treat the
possible symptoms.

13. PREVENTION
• It is based on pre-natal care.
• Regular checkup of pregnant mother.
• Regular monitoring of blood glucose.
• Provide the insulin therapy.
• Provide education and counselling to mothers.
• Conduction of delivery at well equipped hospital with all
modern neonatal intensive care services.
• Provision of adequate antenatal care.
• Educate mother about breastfeeding and care of the baby.
• Early detection and immediate treatment plan should
follow.

14. NURSING MANAGEMENT
• Monitor serum bilirubin level.
• Maintain thermal environment.
• Provide IV glucose according to need.
• Monitor glucose level 3 to 4 hours level not
above 40mg/dl.
• Initiating and maintaining respiration.