Newly published protocol on hypoglycemia in neonates

[Marymoomoo]

The Academy of Breastfeeding Medicine just updated their protocol on hypoglycemia.

"Usual recommendations are that feedings should be frequent, at least 10-12 times per 24 hours in the first few days after birth. However, it is not unusual for term infants to feed immediately after birth in that sacred first hour or two, and then sleep quite a long time (up to 8-12 hours) before they become more active and begin to suckle with increasing frequently. There is always great fear in the postpartum unit when this occurs that all infants, including those with no risk factors for hypoglycemia, will drop their blood sugars. However, normal infants mount protective metabolic responses throughout this time so it is not necessary to try to force-feed them. However, an unusually, excessively drowsy baby must undergo clinical evaluation for other conditions that might be at play. This requires good clinical judgment and assessment so that every normally drowsy infant in those first hours after birth does not undergo any unnecessary work-up that could in addition negatively affect the breastfeeding relationship."

http://bfmed.wordpress.com/2014/06/09/newly-published-abm-clinical-protocol-1-guidelines-for-blood-glucose-monitoring-and-treatment-of-hypoglycemia-in-term-and-late-preterm-neonates-revised-2014/

[chiandre]

I completely agree. Skin-to-skin and breastfeeding should not be interrupted for unnecessary procedures unless the baby shows s/s of hypoglycemia such as jitteriness.

[NurseNora, BSN, RN]

If it's been a long time and you're really concerned, do a blood sugar. Usually it tells you the baby just isn't hungry yet. If it is low, then you can start doing the other stuff.