A newborn infant male delivered to a 25-year-old G5P3, A+ mother at 37 weeks gestation by C section (for non-reassuring fetal heart tones) shows abnormal blood glucose levels. The pregnancy is notable for an antenatal ultrasound diagnosis of cleft lip and palate. Maternal serologies are unremarkable and her prenatal glucose tolerance test is normal. At delivery, blow-by oxygen is given for about 2 minutes for poor color and respiratory effort. Apgar scores are 6 (-2 color, -1 tone, -1 respiratory effort) and 9 (-1 color) at one and five minutes, respectively. Investigations: Vital signs are normal.
Oxygen saturation is 99% in room air. Weight is 3950 gms, height is 54 cm and head circumference is 37.5 cm (all >95th percentile for gestational age). The infant is active and jittery with an obvious left sided cleft lip and palate. Heart is regular without murmurs. Lungs are clear. Abdomen…
