# Why/when do they check blood sugar in a newborn?



## pastrygirl (Jul 21, 2006)

My son's blood sugar was checked right when he was born. It was low, so they said he'd need formula for the first 24 hours until his blood sugar became normal (which it finally did the next morning). After I'd breastfed him the first time about an hour after my c-section, apparently the pediatrician or someone was very upset that they'd "let" me breastfeed. I was horrified! I reluctantly agreed to more formula, but I did continue to breastfeed as much as I could. This was a Saturday afternoon. On Monday morning, the usual hospital pediatrician saw us and said it was ridiculous that they'd given him formula at all. After having a m/c, I was just SO HAPPY that my baby was _alive_, that I didn't fight the formula thing.

I'd like to make sure this doesn't happen again. Is a blood-sugar test routine? Are there circumstances where I really _should_ let them test it, or other circumstances where I can safely decline? I was not diagnosed with GD last time; I take the GTT for this pregnancy in two weeks.


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## mamatolevi (Apr 10, 2009)

I had big babies (no GD) and the nurses all freak out about them b/c their blood sugar can fluctuate more with the big babies. With my first they really pushed the formula b/c he was losing weight (I learned later that the weight he lost was a normal amount and typical of just about baby!) Last time around I put in the birth plan and baby care plan "NO blood tests until after the first nursing." Then I had to time feedings so that the baby had nursed just before they would come in to test. I missed one or two in the 12 or 24 hours (I forget which) but it stilled worked out o.k.

There is no reason to give formula due to blood sugar worries if the mother is breastfeeding on demand. It takes 2-3 days for milk to come in for a vaginal birth and a little longer for c/s (someone please correct me if I have the # of days wrong there) and what the baby needs is colostrum then anyway.


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## pastrygirl (Jul 21, 2006)

I wonder if it was checked because he was 8 pounds 2 ounces... 2.5 weeks early. The nurses were awesome about me breastfeeding and brought me a pump right away and told me to save every last drop. My milk came in pretty quickly, by Monday, I think. We had latch issues but we had no problems with a nipple shield. He nursed very, very frequently after those first 24 hours. He never went 2 to 3 hours between feedings. It was an hour at most, LOL!


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## lifeguard (May 12, 2008)

I had gd & was told because of that they would automatically test the baby's blood sugar because there is a good chance if your sugars are high that when the baby is born & that constant high sugar level is removed the baby can then crash with very low blood sugar. We agreed that we would test the sugar after I first tried to bf & then evaluate from there if formula or glucose would be needed (via syringe or spoon not bottle) to bring his blood sugars up.

That said, ds was doing so well when he was born that they didn't test him at all & I didn't get a chance to try bf him until an hour after because I tore so badly & the stitching took forever. He has ebf from day one.

So, yes, with gd it is pretty standard to test blood sugars but you should be allowed to delay it & try bfing immediately after birth. If they are very low, which can be dangerous (& make them show you the numbers so you know it is low & not just them pushing formula) you may need to supplement but for your bfing relationship it would be better to avoid doing so with a bottle.


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## amydiane (Feb 4, 2009)

From what I understand, it is pretty standard with GD or "big" babies. The hospital I'm delivering at tests at 30 minutes old, 1 hour old, then every 3 hours for 12 hours after that. If everything is fine, they stop. They told me that anything over 40 is considered good, and supposedly they encourage nursing before formula or glucose water (I'll let you know in a few weeks if it's an issue). DH and I haven't decided yet if we're going to allow them to test in the absence of any symptoms (my b/s has been well under control and they'll be monitoring it every hour in labor, so we should know if there's a problem).

The hospital my cousin delivered at gave her baby formula even though his numbers were fine and she told them she was EBFing.







: So it really depends on the hospital and also how willing you are to fight with them about it if they're insistent.

Oh, and I have read that the handheld glucometers tend to read low on newborns, so they can be used to rule out low b/s, but not necessarily diagnose it. Supposedly you can ask for an actual lab test to confirm (and I might need to because my hospital uses the handhelds), but I don't know how much grief they'd give you over it.


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## AmieV (Mar 31, 2005)

Quote:


Originally Posted by *pastrygirl* 
I wonder if it was checked because he was 8 pounds 2 ounces... 2.5 weeks early. The nurses were awesome about me breastfeeding and brought me a pump right away and told me to save every last drop. My milk came in pretty quickly, by Monday, I think. We had latch issues but we had no problems with a nipple shield. He nursed very, very frequently after those first 24 hours. He never went 2 to 3 hours between feedings. It was an hour at most, LOL!

That would be why. They like to test all LGA (large for gestational age) babies. My third baby had several blood sugar draws for this reason, and they all came back fine but apparentlythat's not common.


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## wombatclay (Sep 4, 2005)

Standard here for big babes... but the local providers generally offer a sugar solution (using a dropper, finger, or cup) instead of formula if the blood sugar levels are below what they'd like. They only move to formula if the babe's blood sugar levels don't normalize. Oh, and one of the hospitals here will use pumped breastmilk if you happen to have any. I'll probably pump a little around my due date, freeze it, and bring it in a "lunch box" with an ice pack since I have big kiddos.

Maybe talk with your provider and see if a note can be placed in your file along with the results of the GTT to avoid unnecessary interventions? And ask about formula alternatives and/or alternative dosing techniques like using a cup or dropper.


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## pastrygirl (Jul 21, 2006)

Thank you all for the advice! I had no idea that I could've requested a dropper last time.


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## pageta (Nov 17, 2003)

My doula told me they were doing this at my hospital last time I gave birth. I refused it on the baby portion of my birth plan and got my pediatrician to sign off on it. I wrote that if they saw signs of low blood sugar, they should point them out to me and then we could discuss the options; otherwise I didn't want it checked. My doula said they were using the little deal diabetics use which doesn't give valid results for anyone under 18, so I also insisted on my birth plan that if the blood sugar appeared to be low that labwork be done rather than the little deal they were using on the floor. It wasn't an issue. We nursed right away and they never asked to check it. My doula really wanted me to have some breastmilk from a breastmilk bank on hand in case it was an issue, but I didn't go that far. The breastmilk could be given instead of formula.


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## Mama25 (Jul 20, 2004)

Quote:


Originally Posted by *pageta* 
I refused it on the baby portion of my birth plan and got my pediatrician to sign off on it. I wrote that if they saw signs of low blood sugar, they should point them out to me and then we could discuss the options; otherwise I didn't want it checked. My doula said they were using the little deal diabetics use which doesn't give valid results for anyone under 18, so I also insisted on my birth plan that if the blood sugar appeared to be low that labwork be done rather than the little deal they were using on the floor.


I always have big babies and wasn't going to have them do 5 blood draws (the hospital policy for lga) on my baby unless there were other signs. I breastfeed right at birth and if I couldn't get baby on I would have hand expressed and given by spoon/dropper. Google Jack Newman and his handout on blood sugar for babies for more info. I have known some moms to express just a little around due date and keep it on hand incase they needed some after birth. Also, I agree with how they check it is important and also what number the hospital uses, some hospitals around here use 50 as the number! Keeping the baby skin to skin also helps levels. So don't have the baby taken to bathe or anything. I had to set this up ahead of time with our ped. who agreed to this and it was written in our birth plan and then of course stated again at delivery.


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## pastrygirl (Jul 21, 2006)

Quote:


Originally Posted by *Mama25* 
I have known some moms to express just a little around due date and keep it on hand incase they needed some after birth. Also, I agree with how they check it is important and also what number the hospital uses, some hospitals around here use 50 as the number! Keeping the baby skin to skin also helps levels. So don't have the baby taken to bathe or anything. I had to set this up ahead of time with our ped. who agreed to this and it was written in our birth plan and then of course stated again at delivery.

My son was born almost 3 weeks early... when would you express milk in this case? I have no idea if I'll go early again, though I suspect I will. If I do express, could it cause premature labor?

Was your ped in the hospital? My ped doesn't have privileges in the hospital where I'll give birth. Should I still plan to get something in writing from him?

My husband stayed with the baby the entire time while I was being stitched back up. I didn't have the option for skin-to-skin right after my c-section.


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## pageta (Nov 17, 2003)

Your baby will have to have an attending physician at the hospital where you give birth. If your ped doesn't have privileges there, you will probably be assigned to someone. I would do a little proactive work and find a ped who does have privileges there and is comfortable with your requests.


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## Mama25 (Jul 20, 2004)

Usually expressing just very small amounts (you don't need alot even a 1/2 oz would be fine) would not cause premature labor i.e. moms nurse during pregnancy and it does not cause them to go into labor, so pumping would be the same thing. There is caution recommended if a mom has a history of premature births (before 37wks) or if you have been told not to have sex during your pregnancy since during sex the same hormones are increasing like in breastfeeding. I also have the back up plan that in an emergency my best friend who is nursing who child would provide pumped breastmilk if needed.

Our regular ped didn't have hospital priveleges so I asked him for a recommendation of a ped who does at the hospital I would deliver. I then talked to that ped (I believe it went smooth because my ped recommended him and I told the new ped this so he then felt at ease with taking me on short notice and just for the birth.) I talked to this new ped during my pregnancy to talk about all the hospital policies and the things I wanted---no eye drops, no blood sugars checks for big baby (only if showing signs then I would allow it), what number I want to use for blood sugar and jaundice numbers. Since this was agreed to ahead of time it helped things go smooth since it was a doctor who agreed to this and not just me.


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## mamabear0314 (May 13, 2008)

They tested my son because he was 10 lbs 6.5 oz...no formula though. Maybe because it was a birth center?


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## Girlprof (Jun 11, 2007)

We had an issue with this with my daughter (9 pounds, 10 oz). Actually, we declined the blood sugar test and said we didn't want it unless there were indications that her blood sugar got low. My understanding is that low blood sugar can be pretty serious, but babies don't necessarily have it just because they are on the bigger side. I think my daughter would have been fine except that they had her down at the nursing station trying to do a hearing test on her. We wanted to leave early so we did want the test done but then she started to shake. So, we had an actual indication that something was wrong.

We did start to test her blood sugar then and it was low - can't remember how low, but low enough to worry about. Initially they said we could give her an IV - as a way to avoid giving her formula - crazy. That was some pretty extreme formula avoidance. We said we'd much rather do formula than an IV, but that we wanted to nurse first. Our plan was to nurse her first, then offer some formula, then re-test her blood sugar. Repeat as necessary until we got her levels up. Well, she nursed for over an hour, completely refused the formula (GO BABY!) and her sugar levels were then fine.

What we learned was that 1) this can be a serious issue; 2) nursing might fix the problem and there's no reason not to try that first; 3) some hospitals will go to pretty extreme lengths to avoid giving formula to a breast-fed baby.


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## pastrygirl (Jul 21, 2006)

Quote:


Originally Posted by *Mama25* 
Our regular ped didn't have hospital priveleges so I asked him for a recommendation of a ped who does at the hospital I would deliver. I then talked to that ped (I believe it went smooth because my ped recommended him and I told the new ped this so he then felt at ease with taking me on short notice and just for the birth.) I talked to this new ped during my pregnancy to talk about all the hospital policies and the things I wanted---no eye drops, no blood sugars checks for big baby (only if showing signs then I would allow it), what number I want to use for blood sugar and jaundice numbers. Since this was agreed to ahead of time it helped things go smooth since it was a doctor who agreed to this and not just me.

I love the regular ped at the hospital -- I saw him several times during my son's first year before I switched practices. Plus, he was the one who thought the formula and blood-checking was unnecessary. Had he been there on the weekend, when my son was born, we wouldn't have had the formula issue. (He doesn't accept patients since he's the full-time hospital pediatrician, otherwise I would've considered him as my regular ped.)

I'll see if I can get in touch with him. That would be really, really great!


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## pastrygirl (Jul 21, 2006)

Quote:


Originally Posted by *Girlprof* 
We had an issue with this with my daughter (9 pounds, 10 oz). Actually, we declined the blood sugar test and said we didn't want it unless there were indications that her blood sugar got low. My understanding is that low blood sugar can be pretty serious, but babies don't necessarily have it just because they are on the bigger side. I think my daughter would have been fine except that they had her down at the nursing station trying to do a hearing test on her. We wanted to leave early so we did want the test done but then she started to shake. So, we had an actual indication that something was wrong.

We did start to test her blood sugar then and it was low - can't remember how low, but low enough to worry about. Initially they said we could give her an IV - as a way to avoid giving her formula - crazy. That was some pretty extreme formula avoidance. We said we'd much rather do formula than an IV, but that we wanted to nurse first. Our plan was to nurse her first, then offer some formula, then re-test her blood sugar. Repeat as necessary until we got her levels up. Well, she nursed for over an hour, completely refused the formula (GO BABY!) and her sugar levels were then fine.

What we learned was that 1) this can be a serious issue; 2) nursing might fix the problem and there's no reason not to try that first; 3) some hospitals will go to pretty extreme lengths to avoid giving formula to a breast-fed baby.

Oh my, I would definitely choose formula over an IV, if those were my choices. Though I'm pretty sure my son DID get an IV or at least a heplock. (When my husband was with him.) His foot was all bandaged for a few days.







ETA: Yes, he did have a heplock and my husband is pretty sure that they gave him glucose through the line.

I'll really need to push more for breastfeeding, even if it's not convenient for the nurses who need to test the blood sugar. I really think it all boiled down to convenience, which makes me sad.


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## Full Heart (Apr 27, 2004)

Ds was 9 lbs 2 oz and he had his bs tested w/in mins of birth. Then every few hours till we left. One time it was low (despite nursing on demand) and the nurse "let" me nurse again and retest it instead of going right to the sugar water in dropper. His bs more than doubled. The nurses were in shock and I was accused of sneaking him formula LOL.

The fact your ds had a hep lock I have to wonder what his levels were. If he had any symptoms of low bs. If he already had a hep lock I don't see why you couldn't nurse. What would be the point of the formula then? kwim?

Testing the bs where I was at was not a big deal. They tested him in bed with me or in his bed next to me. I wouldn't have mattered how he was fed.


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