Your policy for monitoring nb glucose?

[mitchsmom]

One of the other threads got me wondering about this. What is your routine/policy for monitoring newborn glucose?

The AAP and others seem to recommend only for at-risk babies, so I was wondering if you do all babies or just at-risk ones? Do you do it before or after feeding? And do your babies feed right away after birth? Do they stay with mom after for feeding on demand?:

http://aappolicy.aappublications.org/cgi/reprint/pediatrics;92/3/474.pdf

"... no study has shown that treatment of a transient low blood glucose level offers a better short-term or long-term outcome than the outcome resulting with no treatment. ... Furthermore, there is no evidence that asymptomatic hypoglycemic infants will benefit from treatment."

More:

http://www.bflrc.com/newman/overheads/Hypoglycemia.htm

http://www.bfmed.org/protocol/proto1.html

http://www.aafp.org/afp/20001115/tips/14.html

http://www.kellymom.com/babyconcerns/bfhelp-baby.html#Hypoglycemia

[imenid37]

At risk or symptomatic babies at 1&3 hours of age w/ f/u for readings below 40. I used to work at a place that did one on all babies at 1 hour of age. Another place, once we started a "series" which was 1/2 hr of age, 2 hrs of age, 1 hr. pc the first feeding, and ac 3 more feedings we had to finish it! This was even when we did 1 glucose just to check if temp was low or baby was a little jittery! That was 8 years ago, so perhaps they too have backed off a little too.

[SmilingBluEyes]

At risk or symptomatic babies at 1&3 hours of age w/ f/u for readings below 40. I.

Similar to ours. At-risk (includes IUGR, SGA, LGA, IDDM, Gest DM, Moderate to thick Meconium staining, drug exposure, Severe fetal distress to name a few), ALL get blood sugar tested within first 30 minutes of life. If below 40, we repeat with stat lab blood glucose and start feeding (unless sick). If lab verifies below 40, call pediatrician. We need to have THREE blood glucoses above 45 in a row (before feedings) and then we back to one more at 12 hours and another at 24 hours. All glucose tests are done prior to feeding. Breast feeding is done FIRST then formula by cup supplementation afterward in breastfed babies. Usually, if they persist below 40, we have to start D-10 IV. Whole protocol for that based on weight of infant.