Prophylactic sucrose via the tahneek technique and its effect on neonatal hypoglycemia randomized control trial

Abstract

Background

The study examined the medical impact of tahneek with dates on hypoglycemia in high-risk newborns. Tahneek, an Islamic tradition, may offer benefits such as stimulating mouth muscles and aiding in breastfeeding initiation. The study assessed its efficacy in comparison with routine feeding practices on blood glucose levels and neonatal intensive care unit (NICU) admissions in high-risk newborns. By addressing neonatal hypoglycemia risks, this research uniquely explored the potential synergy between tradition and contemporary medical strategies.

Methods

This single-center, open-label, randomized controlled clinical trial was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia, and included neonates at risk of developing hypoglycemia. A total of 324 subjects participated: 162 in the intervention group, 162 in the control. The intervention group received a single dose of soft date paste containing glucose equivalent to 200 mg/kg at 1 h after birth; the control group received routine feeds. Blood glucose levels were monitored by standard protocols.

Conclusions

The main outcome measures included the incidence of hypoglycemia and the need for NICU admission for hypoglycemia. The study found no significant difference in hypoglycemia incidence (11.7 vs 14.11, p = .51) or NICU admissions for hypoglycemia (0.12% vs 0.18%, p = .69) between the intervention and control groups, respectively. Exclusive breastfeeding showed a slight preference in the intervention group. Study concluded that tahneek with dates did not reduce the occurrence of hypoglycemia or the need for NICU admissions. However, the practice was deemed safe, culturally accepted, noninvasive, and well tolerated by neonates.

Keywords

neonate hypoglycemia tahneek dates NICU Islamic tradition

Get full access to this article

View all access options for this article.

References

Cornblath

Hawdon

Williams

, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics 2000; 105(5): 1141–1145. https://doi.org/10.1542/peds.105.5.1141

Committee on Fetus and Newborn Adamkin

. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics 2011; 127(3): 575–579. https://doi.org/10.1542/peds.2010-3851, Epub 2011 Feb 28. PMID: 21357346.

Screening guidelines for newborns at risk for low blood glucose. Paediatr Child Health 2004; 9(10): 723–740. https://doi.org/10.1093/pch/9.10.723

Thompson-Branch

Havranek

. Neonatal hypoglycemia. Pediatr Rev 2017; 38(4): 147–157. https://doi.org/10.1542/pir.2016-0063

Thornton

Stanley

De Leon

Harris

Haymond

Hussain

Pediatric Endocrine Society , et al. Recommendations from the pediatric endocrine society for evaluation and management of persistent hypoglycemia in neonates, infants, and children. J Pediatr 2015; 167(2): 238–245. https://doi.org/10.1016/j.jpeds.2015.03.057, Epub 2015 May 6.

Edwards

Liu

Hegarty

, et al. Oral dextrose gel to prevent hypoglycaemia in at-risk neonates. Cochrane Database Syst Rev 2021; 5(5): CD012152. https://doi.org/10.1002/14651858.CD012152.pub3

Edwards

Liu

Battin

, et al. Oral dextrose gel for the treatment of hypoglycaemia in newborn infants. Cochrane Database Syst Rev 2022; 3(3): CD011027. https://doi.org/10.1002/14651858.CD011027.pub3

Roberts

Lin

Alsweiler

, et al. Oral dextrose gel to prevent hypoglycaemia in at-risk neonates. Cochrane Database Syst Rev 2023; 11(11): CD012152. https://doi.org/10.1002/14651858.CD012152.pub4

Harris

Weston

Signal

, et al. Dextrose gel for neonatal hypoglycemia (the sugar babies study): a randomised, double-blind, placebo-controlled trial. Lancet 2013; 382(9910): 2077–2083. https://doi.org/10.1016/S0140-6736(13)61645-1

10.

Hegarty

Harding

Gamble

, et al. Prophylactic oral dextrose gel for newborn babies at risk of neonatal hypoglycemia: a randomised controlled dose-finding trial (the Pre-hPOD study). PLoS Med 2016; 13(10): e1002155. https://doi.org/10.1371/journal.pmed.1002155

11.

Rawat

Chandrasekharan

Turkovich

, et al. Oral dextrose gel reduces the need for intravenous dextrose therapy in neonatal hypoglycemia. Biomed Hub 2017; 1(3): 1–9. https://doi.org/10.1159/000448511

12.

Ter

Halibullah

Leung

, et al. Implementation of dextrose gel in the management of neonatal hypoglycemia. J Paediatr Child Health 2017; 53(4): 408–411. https://doi.org/10.1111/jpc.13409

13.

Makker

Alissa

Dudek

, et al. Glucose gel in infants at risk for transitional neonatal hypoglycemia. Am J Perinatol 2018; 35(11): 1050–1056. https://doi.org/10.1055/s-0038-1639338

14.

Glasgow

Harding

Edlin

. Cost analysis of treating neonatal hypoglycemia with dextrose gel. J Pediatr 2018; 198: 151–155.e1. https://doi.org/10.1016/j.jpeds.2018.02.036, Epub 2018 Apr 3.

15.

Newnam

Bunch

. Glucose gel as a treatment strategy for transient neonatal hypoglycemia. Adv Neonatal Care 2017; 17(6): 470–477. https://doi.org/10.1097/ANC.0000000000000426

16.

Meneghin

Manzalini

Acunzo

, et al. Management of asymptomatic hypoglycemia with 40% oral dextrose gel in near term at risk infants to reduce intensive care need and promote breastfeeding. Ital J Pediatr 2021; 47: 1–8. https://doi.org/10.1186/s13052-021-01149-7

17.

Gibson

Carter

LeDuff

III , et al. 40% Glucose gel for the treatment of asymptomatic neonatal hypoglycemia. Adv Neonatal Care 2021; 21(5): 371–378. https://doi.org/10.1097/ANC.0000000000000823

18.

Desai

Verma

Bhargava

, et al. Implementation and outcomes of a standard dose dextrose gel protocol for management of transient neonatal hypoglycemia. J Perinatol 2022; 42(8): 1097–1102. https://doi.org/10.1038/s41372-021-01284-3

19.

Gupta

Amboiram

Balakrishnan

, et al. Dextrose gel for neonates at risk with asymptomatic hypoglycemia: a randomized clinical trial. Pediatrics 2022; 149(6): e2021050733. https://doi.org/10.1542/peds.2021-050733

20.

Parappil

Gaffari

Ahmed

, et al. Oral dextrose gel use in asymptomatic hypoglycemic newborns decreases NICU admissions and parenteral dextrose therapy: a retrospective study. NPM. J Neonatal Perinat Med 2023; 16(1): 111–117. https://doi.org/10.3233/NPM-221170

21.

Zhang Cr Aldosari

Vidyasagar

, et al. Determination of the variability of sugars in date fruit varieties. J Plant Crop 2015. Available from. academia.edu