A 3,900-g male infant is born via spontaneous vaginal delivery to a 36-year-old G6P3 registered woman. Delivery is complicated by a tight double nuchal cord. Maternal laboratory results are unremarkable with group B streptococci culture negative. Membranes ruptured 2 hours before delivery with clear fluid and there is no maternal fever. There is no history of maternal medications. Apgar scores are 9 at both 1 and 5 minutes.

Upon admission to the well infant nursery, the Dextrostix is noted to be 32 mg/dL 1 hour after delivery and despite early initiation of formula feedings. The follow up Dextrostix is 26 mg/dL, so the infant is transferred to the NICU for management of hypoglycemia. The infant has a normal newborn examination except for some facial petechiae attributed to the tight nuchal cord. Vital signs are within normal limits. An intravenous (IV) infusion of D10W is begun at 80 mL/kg per day,...

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