Infant feeding: five per cent glucose solution

Five per cent glucose solution is no longer commercially available. This guideline explains how a solution can be made up on the ward by adding dextrose monohydrate (eg Nutrivit glucose powder) to a 90ml bottle of sterile water.

Background

Prior to gastrointestinal surgery or investigation, it is often neccessary to give children only clear fluids for 24 hours. In this context, any fluid except milk or milk products can be given. It is usual to give older children fruit squash or carbonated drinks. Babies under the age of one are given a 5% glucose solution to maintain their blood sugar level.

Adding glucose powder to sterile water

This procedure should be carried out as an aseptic non-touch technique in a clean area of the ward; the ward treatment room should be used when available (Rationale 1).

This procedure should be regarded as the administration of an oral medicine and can be single-checked and carried out by a registered nurse, as per the Great Ormond Street Hospital (GOSH) Administration of Medicines policy.

If the solution is prepared by a student nurse or a healthcare assistant, it must be checked by a registered nurse prior to administration.
Glucose powder should be stored in a locked medicine cabinet and its expiry date must be checked prior to every solution preparation. (Rationale 2)

  • Check 90ml bottle of sterile water has not been opened. Seal should be intact; reject the bottle if the safety button is raised. (Rationale 3)
  • Ensure the water is within the expiry date. (Rationale 4)
  • Open the bottle of water and add one level yellow scoop of glucose powder - scoop available from ward dietitian.
  • Reseal bottle and shake vigorously for 30 seconds. (Rationale 5)
  • Place a patient identification sticker on bottle. Write on it the time and date the glucose was prepared and that it is five per cent glucose. (Rationale 6)

Please note: All three-year course pre-registration student nurses must have all feeds double checked by a qualified member of the nursing staff prior to administration.
This bottle of glucose must be refrigerated and can be kept for up to 24 hours. After this time it should be discarded. (Rationale 7)

Rationale

Rationale 1: To prevent contamination of feed.
Rationale 2: To prevent unauthorised use.
Rationale 3: To ensure water is sterile.
Rationale 4: To ensure water is safe to use.
Rationale 5: To ensure glucose powder is dissolved fully.
Rationale 6: To ensure it is seen to be five per cent glucose, not water, and is given to the correct infant.
Rationale 7: To minimise bacterial growth and prevent contamination.

References

Reference 1:
Leys CM, Austin MT, Pietsch JB (2005) Elective intestinal operations in infants and children without mechanical bowel preparation. Journal of Paediatric Surgery 40: 978-982.
Reference 2:
Wilson CM (2005) Perioperative fliuds in children - Update in Anaesthesia 19. www.nda.ox.ac.uk/wfsa/html/u19/u1914_01.htm. Viewed on: 23/07/2008 

Document control information

Lead Author(s)

Helen Johnson, CNS Stoma care, Paediatric surgery

Additional Author(s)

Vanessa Shaw, Head of Dietetics

Document owner(s)

Helen Johnson, CNS Stoma care, Paediatric surgery

Approved by

Guideline Approval Group

Reviewing and Versioning

First introduced: 
22 July 2008
Date approved: 
13 January 2015
Review schedule: 
Three years
Next review: 
13 January 2018
Document version: 
2.0
Previous version: 
1.0