At risk means many different things. A premature baby may not be able to mobilize other sources of nutrients the way a full term baby can usually, so that there is more urgency to treat that baby. A large for gestational age baby, if he is overproducing insulin also might not be able to mobilize other energy sources. But the overproducing of insulin comes from poorly controlled maternal diabetes, and if the mother is well controlled, there shouldn't be a problem. Again, why give formula first if the baby is symptomatic? I feel this is dangerous. What if he has a seizure before the ABM has a chance to be effective? He might aspirate on top of everything else. Symptomatic, that means IV and rapid and *reliable* correction of the blood sugar as far as I can see. In fact, I would be surprised that most paediatricians would treat symptomatic hypoglycemia with formula only and wait to see what happens. Truthfully, I feel this is a very risky approach. The IV. As far as the asymptomatic baby is concerned, feed the baby, absolutely. And that means breastfeeding. That will increase the sugar. If you use a lactation aid to supplement sugar water at the breast (and I would not use 10%, but rather 5%, it'll be alright). In that case the baby gets both. Where does it say it doesn't work? It's always worked for me. Jack Newman, MD, FRCPC *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html