The breast milk with more calories released later in the feeding is:

Step 1 is 3000 grams ÷ 1000 = 3 kg.

Step 2 is 3 kg × 24 mg = 72 mg.

Step 3 is 72 mg ÷ (50 mg ÷ 5 ml) = 1.2 ml.

Answer: 1.2 ml.

Choice A rationale

• Normal neonatal glucose: >45 mg/dL (ideally 50–110 mg/dL).

• A level of 40 is low → risk for hypoglycemia complications (seizures, brain injury).

While it is important to monitor glucose levels, a reading of 40 mg/dL is low and requires immediate attention. Waiting 4 hours could allow the newborn's condition to deteriorate further. Hypoglycemia in newborns can lead to serious complications if not treated promptly.

Choice B rationale

Assessing for hypothermia is essential, but it is not the first priority when a newborn has low blood glucose levels. Immediate steps should be taken to address the hypoglycemia to prevent further complications, as it is a more immediate threat to the newborn's health.

Choice C rationale

Notifying the physician on call is the correct priority intervention. A blood glucose level of 40 mg/dL is concerning, and prompt medical intervention is necessary. The physician can order appropriate treatment to stabilize the newborn's glucose levels and prevent potential complications.

Choice D rationale

Re-evaluating the blood serum glucose is important but comes after initiating immediate intervention. Continuous monitoring should follow initial treatment to ensure the newborn's glucose levels stabilize. Immediate action is crucial to address the hypoglycemia effectively.