# What should be done for babies with low blood sugar?



## MsElle07 (Jul 14, 2006)

I'm not a big believer in big babies = gestational diabetes = baby with low blood sugar. It's usually not true and it generally leads to formula supplementation.

So, let's say a baby exhibits signs of low blood sugar. In an ideal world, what SHOULD be done for them? Is the tiny amount of colostrum enough to even out their blood sugar?

I know that when my blood sugar is low, I get shaky and sweaty and nauseated and can't think straight. I wouldn't want to subject a baby to feeling that way. But neither would I want to supplement.


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## FreeThinkinMama (Aug 3, 2004)

I've been reading about this too because I think that even though my first dd's blood sugar was normal (62) after birth, I think the nurses gave her a supplement when they took her to do testing, despite my telling them not to. I had GD but dd was born at a normal weight of 7.14 and had no symptoms of low blood sugar so there was no reason to. I have a SIL though who didn't even have GD and they supplemented her baby just because diabetes ran in her family, even though the babies sugars were fine.

At any rate, I've read different opinions about the ideal level. Some more conservative pediatricians want to see 40, others are okay if the levels are above 36 as long as the baby isn't showing symptoms of hypoglycimia. Yes, collostrum should be enough to bring the babies sugars back up. They should allow mom & baby to have a few feedings before resorting to supplements and they should retest sugar levels after feedings. Here's some links with good info I found:

http://www.kellymom.com/babyconcerns...oglycemia.html
http://www.lalecheleague.org/NB/NBJulAug97p107.html
http://newborns.stanford.edu/Hypogly...html#screening


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## pamamidwife (May 7, 2003)

I think the hard thing is that we dont' really have good concrete numbers about what is normal and what is abnormal - in fact, there might be some benefit to lower blood glucose in babies, we just don't test every single baby.

I've only had one baby that I suspected low blood sugar and I didn't test him (I think the stress from poking them actually creates a huge high in stress hormones followed by a depletion in blood sugar, giving a false low reading). He was 13 lbs and didn't look "right". Mom got milk from a friend who was breastfeeding.

I think that if we would stop starving women in labor that would be a plus, but this whole idea of poking and treating any baby over 8 and a half pounds is crazy.


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## ~pi (May 4, 2005)

I have type 1 diabetes (a.k.a. juvenile diabetes) so I've done a lot of reading on this.

It's a tough one because while there are documented risks to neonatal hypoglycemia (seizures, brain damage, death) no one actually knows what a normal blood sugar reading is for a newborn.

IMHO, based on research, babies with blood sugar below about 40 mg/dL or 2.6 mmol/L and who are asymptomatic for hypoglycemia should be breastfed and tested again in about an hour. Symptomatic babies are a different kettle of fish. I think there is decent evidence to support treating them via IV dextrose.

However, I think the most important thing would be to prevent the low blood sugars in the first place -- initiate breastfeeding asap after birth and keep baby skin to skin with mom for warmth and comfort (being cold and being stressed both cause babies' blood sugar to drop.)

These practices are not guarantees, but I think it's dramatically stupid to take babies who may be at higher risk of hypoglycemia and do things to them that increase their risk of hypoglycemia, namely, take them away from their mothers.









FWIW, my son's initial blood glucose was 1.4 mmol/L (about 25 mg/dL.) He got colostrum that I pumped during pregnancy for just such an unfortunate occurance, followed by IV dextrose. (I would have preferred to breastfeed him but he was in the NICU and I was in recovery.)

This is a research-based, pro-breastfeeding protocol that came out recently:

http://www.bfmed.org/ace-files/proto...poglycemia.pdf


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## ahdoula (Sep 5, 2006)

I didn't have time to read all the replies, dh just waked in the door, so maybe this was covered. But in my training as a CLC we were taught that if the blood sugar is low then colostrum is plenty to get it back up and a baby does not need supplementing. If staff insists on seeing how much goes in to the baby, then hand express onto a teaspoon and spoon feed teaspoons. With in a short time if they retest they should see a rise in blood sugar. HTH


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## pamamidwife (May 7, 2003)

Quote:


Originally Posted by *~pi* 
However, I think the most important thing would be to prevent the low blood sugars in the first place -- initiate breastfeeding asap after birth and keep baby skin to skin with mom for warmth and comfort (being cold and being stressed both cause babies' blood sugar to drop.)

These practices are not guarantees, but I think it's dramatically stupid to take babies who may be at higher risk of hypoglycemia and do things to them that increase their risk of hypoglycemia, namely, take them away from their mothers.










yes! yes!! yes!!!!


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## mamaverdi (Apr 5, 2005)

I agree with ~pi. The other thing I would add is that despite what doctors may say, full newborn screening is medically indicated for a newborn who has symptomatic hypoglycemia, apnea, or other "issues/non-issues."

www.pediatrix.com offers the most comprehensive screening at this time. NAYY.


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## MsElle07 (Jul 14, 2006)

Can anyone tell me what a symptomatic newborn looks like?

Thanks for all your help so far!


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## wasabi (Oct 12, 2004)

DD#2 was a big girl and hospital protocol said they needed to test her blood sugar three times. The first time it was lowish (45) which was not a big surprise considering she had slept for a long time at that point. She nursed and was fine after that. So yes I think in most cases just the colostrum will do it. What was a little annoying was they wanted to test her every three hours but she couldn't have nursed before they tested her. Well let me help you out if you don't let her eat for three hours her blood sugar's going to be a little low. Once she nurses it will be fine again. I pretty much just did whatever DD seemed to need and they left us alone after it was clear she was fine.


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## Morgraine (Mar 1, 2004)

I saw Dr. Newman speak and he was really informed on the issue. He basically said nurse them!


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## angelpie545 (Feb 23, 2005)

I think for most cases that nursing them would be the answer. I suspect that there might be those few extreme cases where intervention is needed, but I don't think it's as common as doctors make it out to be. My first daughter was 9lbs and 5oz. I don't believe we tested her blood sugars at all. She was born in an out of hosptial birth center, and was fine. I think it's kind of ridiculous to test sugars just based on the baby's size. I did not have GD during my pregnancy; Destiny was just a big baby. She wasn't fat either, just long, lean, and muscular, the same as she is now.


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## Shawnee (Sep 15, 2006)

Both of my babies had low blood sugar at birth. The first was given several bottles before I saw her, and then I was told to supplement bm with formula at every feed. Her blood sugar remained low for 2 days, then I said "No more supplementing!" and her very next test was normal and remained so.

With my second baby, I fought hard to keep him with me and nursed him soon after birth. His next test was normal and remained so.

I know it isn't scientific, but it just feels like formula was causing the low blood sugar in my first baby. Has anyone ever heard this suggested before?


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## ~pi (May 4, 2005)

Quote:


Originally Posted by *MsElle07* 
Can anyone tell me what a symptomatic newborn looks like?

Thanks for all your help so far!

From the pdf I linked above:

TABLE 3. CLINICAL MANIFESTATIONS OF
POSSIBLE HYPOGLYCEMIA
Irritability, tremors, jitteriness
Exaggerated Moro reflex
High-pitched cry
Seizures or myoclonic jerks
Lethargy, listlessness, limpness, hypotonia
Coma
Cyanosis
Apnea or irregular breathing
Tachypnea
Hypothermia; temperature instability
Vasomotor instability
Poor suck or refusal to feed


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## mamaverdi (Apr 5, 2005)

Quote:


Originally Posted by *Shawnee* 
I know it isn't scientific, but it just feels like formula was causing the low blood sugar in my first baby. Has anyone ever heard this suggested before?

Yes, there are many reasons why this could be true. I don't have time to go into it right now, but basically think of what collustrum is, how it's designed to be delivered, small amounts often/all-the-time, and think about the transition from womb-feeding to breastfeeding. Formula feeding goes against all of that.

Also, another poster mentioned that the baby couldn't nurse before the blood sugar readings: it can be very dangerous to keep a hypoglycemic baby from nursing just to test blood sugars. How ridiculous! What a dangerous protocol that was!


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## dantesmama (May 14, 2006)

Gah! This thread opens up old scars for me. When DS was born (barely over 7lbs, mind you, and no gestational diabetes) the nurses told me that his blood sugar levels were very low and I had to go x amt of time w/o nursing him so they could retest a few times. I was also told I needed to supplement or he would end up in the NICU. Well, I continued nursing him anyway (and was actually yelled at by the nurses who walked in on me nursing him) and I wouldn't give him the formula bottles, although I know he got them at night because the hospital staff would under no circumstances allow him in my room overnight. The next day I spoke with our ped who told us that the blood sugar levels were barely borderline all along. There was no reason for any intervention whatsoever.

Just my experience.


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## Shawnee (Sep 15, 2006)

Quote:


Originally Posted by *ahdoula* 
If staff insists on seeing how much goes in to the baby, then hand express onto a teaspoon and spoon feed teaspoons

The nurses tried to get me to prove I had some colostrum/milk by pumping. I'm glad I was a second time mum and had the sense to refuse this. Many of us will not produce unless baby is latched on. Two of the four women in my ward stopped breastfeeding because they couldn't produce anything for the pump.

Quote:


Originally Posted by *dantesmama* 
Gah! This thread opens up old scars for me.

((HUGS)) Yeah, me too. It hurts to know that my babies suffered because of the useless, senseless tests they were subjected to. Ds was a month old and still had marks on his heels. He was 10 lb 1 oz so he was treated to lots of extra "attention" than if he'd been 9 lb 15 oz.

Anyway, I really appreciate the info from this thread. Knowledge is power.


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## October16Mom (Jul 10, 2006)

I had GD and my FP dr. (love that woman) wouldn't let them do the sugar test until after I had nursed her. That being said, I was in complete control of my sugars. Now DH (FP doc) has had a few cases of infants with tremors/extremely low blood sugars. But this was only in women who ate what they wanted to and lied to him about their sugars and were very non-compliant as far as controlling their sugar. The thing is, these same women who don't care about protecting their baby from diabetes/gestational diabetes don't care enough about their baby to breastfeed... Interesting discussion!


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## Samjm (Mar 12, 2005)

Thanks for all the info! I have Type 1 Diabetes, so they always test babies because of all the extra insulin floating around in my body. DD's sugar was just less than 20. It was very scary. They gave her a little formula with a tube, and her sugars got back to normal levels.

I'm still not sure what we'll do with this baby. 20 is VERY low in my opinion. If her sugars were just a bit higher I'd have refused the formula.

DD was 6lbs 3oz at birth.


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## raeinparis (Sep 26, 2005)

thanks mamas. i have a friend in hospital now with her baby who was born on the 7th. she was 9.5 lbs, which is the size of a three month old in france... her glucose level has dropped to 28 from the upper 30s. they had been giving the baby supplemental dextrose stuff by bottle but this knocked her out for four hours at a time and my friend's crunchy midwife told her to pour the bottle down the sink and just nurse. the baby also has a slightly floppy arm, which my friend was told was probably from the birth (cord wrapped around baby) but after searching around (at her request), i think this may be a factor in the hospital freaking over her levels. dunno though. i just woke up to a text message asking me to google her symptoms. i figured checking mdc would be better!


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## tinyshoes (Mar 6, 2002)

What effects does starving the laboring mother have on newborn babies' blood sugar?

or if mama has had just an IV all day?


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## October16Mom (Jul 10, 2006)

Good point! They were extra lenient with me since I had GD. I sipped on fruit juices until just a few hours before giving birth.


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## nathansmom (Nov 28, 2003)

My child was born with very low blood sugar (15). He spent 9 days in the nicu. He wasn't real big (8lbs 14oz) and I did not have GD. I was not starved during my labor, my ob told the hospital I was allowed to eat when and how much I wanted and I did. My child took 5 days to get his sugar levels up to 30 and another 4 days to get them into the 50's which is what was required for him to go home. He was treated with iv fluids and donated breastmilk. He took almost 6 days to learn how to suck and was tube fed during those first 6 days. After he was released from the hospital we had daily blood sugar tests done until he maintained his levels in the 70's on his own.


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