Approximately 15% of all babies or 10,000 per annum in New Zealand develop hypoglycaemia (low blood glucose) after birth, of whom 20% require admission to neonatal intensive care for severe or recurrent hypoglycaemic episodes. These infants often have prolonged hospital admission, ongoing hypoglycaemia despite provision of intravenous fluids, difficulty establishing feeding due to glucose instability, and frequent invasive blood testing. Despite best current management, these infants are at high risk of brain injury and later learning disability, and new treatment approaches are needed. We are investigating whether early use of oral diazoxide, a medicine that targets dysregulated insulin secretion, in severe or recurrent neonatal hypoglycaemia, improves glucose stability, reduces the need for intravenous glucose, shortens neonatal unit admission and facilitates earlier introduction of feeds. By optimising metabolic transition, diazoxide has the potential to reduce long-term risks of neurocognitive impairment in severe or recurrent neonatal hypoglycaemia.