New Granddaughter!!!

TexasPediRN · Apr 15, 2006

Congrats on the new granddaughter!

I'm actually not quite sure if I can answer your question..but your story reminded me a lot of two patients that I cared for last year. They were siblings, brother and sister, 3 and 8, respectively. Their mother had told me their story one night and it sounded just like your granddaughters. Couldnt maintain sugar levels... turns out they both had something called Glycogen Type 1 Storage Disease. Easily maintainable. Blood sugar checks QID, corn starch feedings at night to maintain sugar levels, strict diets, and NG tubes as infants/toddlers, as well as hospitalizations each time they got sick to maintain sugar levels.

Now I dont know your granddaughters whole story, and im not giving medical advice since thats not allowed, but these 2 kids popped into my head as soon as i read your post, and I just wanted to mention it.

I do hope they can find the cause of the low blood sugar and figure things out! I'm sure some other NICU nurses will be able to answer your question and maybe there is a simple rationale for why she isnt maintaining her blood sugar levels.

I cared for these children on the peds floor, and I dont know if some other more experienced nurses have some thoughts on this matter for you!

Again, congrats on the new grandaughter! Please let us know what happens :)

-Meghan :nurse:

JacqueOCS · Apr 15, 2006

thanks for the quick response. i am anxious to see how she does through out the day. kelly (mollys mama) said they are going to weigh molly before she nurses at noon and then again after feeding to see if she is taking in much breast milk. one of the nicu nurses told kelly & jace that even though she goes after the breast like she's never has it before ..... that she may not be getting much milk and that is why her blood sugar keeps bottoming out.

thanks meghan for sharing that w/me. i'll let you know how she does.

happy easter!

jacque

TexasPediRN · Apr 15, 2006

True, like I said I was hoping there was a much simpler explaination! The story just reminded me so much of these 2 siblings that I had wanted to mention it, because I know what this mom had gone through getting the first one diagnosed.

She should be getting some colostrum via breast for the first few days, and even though she may loose weight in the first few days (normal) her blood sugar should be maintained with the colustrum. After a few days moms milk production should kick in.

Have a nice Easter, and keep us informed please :)

-Meghan

prmenrs, RN · Apr 15, 2006

A Reminder: We cannot give medical advise!

I am closing this thread.

Home Health Columnist / Guide · Apr 16, 2006

i know what it's like to have a nicu infant 7.5 lbs at 36 weeks (my second son)seen next to the roomate weighing 1.5 lbs...sureal .

my homecare agency process about 50 referrals per week for maternal child wellcare visits. about 15 patients per week were babies brought to nicu due to low blood sugar, often found in premature infants and those larger for gestational age. recommendation often is q 3 hr feedings.

some references for you.

abnormal blood sugar

because premature newborns have difficulty maintaining normal blood sugar (glucose) levels, they are often treated with intravenous glucose solutions or given small frequent feedings. without regular intake of sugar, a newborn may develop low blood sugar levels (hypoglycemia). most newborns with hypoglycemia do not develop symptoms. others may become listless with poor muscle tone, feed poorly, or become jittery. rarely, seizures may develop. http://www.merck.com/mmhe/sec23/ch264/ch264c.html

great info: low sugar in the blood :

what does it mean for your breastfeeding baby? by ann calandro http://breastfeed.com/resources/articles/lowsugar.htm

screening guidelines for newborns at risk for low blood glucose

how is neonatal hypoglycemia defined?

eonatal hypoglycemia cannot be defined by a single value of glucose applicable to all clinical situations and to all infants. it appears that infants may develop signs suggestive of hypoglycemia over a range of blood glucose levels that is substantially lower than normal adult levels.

“in approximate order of frequency there are jitteriness or tremors, apathy, episodes of cyanosis, convulsions, intermittent apneic spells or tachypnea, weak or high-pitched cry, limpness or lethargy, difficulty in feeding, and eye rolling. episodes of sweating, sudden pallor, hypothermia, and cardiac arrest and failure also occur. there is frequently a clustering of episodic symptoms. because these clinical manifestations may result from various causes, it is critical to measure serum glucose levels and to determine whether they disappear with the administration of sufficient glucose to raise the blood sugar to normal levels; if they do not, other diagnoses must be considered” (2)

http://www.cps.ca/english/statements/fn/fn04-01.htm

emedicine - pediatrics, hypoglycemia : article by hilarie cranmer ...

hope you find this info helpful.