What is Known: • Oral 40% dextrose gel is recommended for asymptomatic neonatal hypoglycemia but is unavailable in many under-resourced healthcare settings. • Intravenous dextrose is effective but may disrupt mother-infant contact and breastfeeding.

What is New: • Buccal 50% dextrose increased blood glucose more than placebo but did not reduce IV dextrose use. • No episodes of hyperglycemia, choking, vomiting, or mucosal irritation were observed in either group during routine clinical monitoring.