In recent years, propranolol hydrochloride (sometimes known by the brand name Hemangeol) has become a more popular treatment option for infantile hemangiomas in the facial area, which you may know better as a strawberry mark, angel kiss, stork bite, or port-wine stain. While propranolol can be a successful treatment for many babies, it's not suitable for everyone. Here are 2 situations where propranolol might not be the best course of action. For more information on what medication or surgery might be appropriate, talk to an experienced paediatric vascular surgeon.
While studies have found that propranolol can reduce the size of large hemangiomas, many vascular specialists recommend surgery for severe cases on the face. This is because propranolol can take a long time to work (with many treatment courses lasting up to eighteen months), and facial hemangiomas can affect your baby's quality of life. If, for example, your baby is unable to open his eye or struggles to eat due to their swelling, eighteen months might be too long to wait to see significant improvement. Remember that discomfort isn't the only problem that arises from a large hemangioma; nutrition, learning, and other essential processes could also be at stake. If your baby has a large hemangioma that's impeding their ability to function as normal and you are interested in propranolol, ask your vascular specialist about a possible trial course of the medication. As some children with severe cases of the condition see improvement in just a few days, it may be worth trying the drug before moving on to surgery.
Low Blood Sugar Risk
Propranolol hydrochloride isn't without its side effects. One of the most concerning is that it can cause low blood sugar, known medically as hypoglycaemia. Low blood sugar can cause a range of problems for your baby. At the less serious end of the scale, your child could experience a rapid heartbeat or sweating. More serious cases of low blood sugar can cause confusion, seizures, and even fainting. This can be very dangerous for young infants who already lack the stability of an older child. That's why it's important to avoid propranolol for a baby who's already at risk of getting low blood sugar. This includes children who were premature or had low birth weight, babies of mothers who suffered from gestational diabetes, and infants who were temporarily asphyxiated during birth. Other complications like heart problems, low blood pressure or high blood pressure, asthma and breathing difficulties, or allergies can also be worsened by propranolol treatment, so make sure you discuss your baby's entire medical history with the vascular surgeon before making a decision about treatment.