I have relied heavily on the referenced info in BFG & HUMAN LACTATION
which suggests that 30mg should be the minimum for the first day of life
rather than 40. Especially noteworthy is the comment that glucose serum
levels will rise on their own during the first day, even without
additional feedings! Putting baby to breast early and frequently is
usually sufficient.

I think that it is important to also screen for risk factors, such as
maternal diabetes, maternal glucose IV during labor, extreme infant
lethargy and the other related signs, as these can add valuable
information in determining true problems.  I have unfortunately seen the
panic button pushed in my community for babies who had no risk factors
and appeared normal and healthy but displayed a few occasional tremors
(including just after a circ!)  with glucose readings of just under 40mg.
I concur with the referenced researchers who suggest that maybe we need
to redraw the "accepted guidelines", as otherwise fully 25% of newborns are
going to be considered sub-normal. While we do have many labor management
practices (ie no food during labor) that can legitimately cause some of these
crises, I have a hard time believing that nature otherwise messes up so
often.

-Lisa

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Lisa A. Marasco, IBCLC                                /  [log in to unmask]
International Board Certified Lactation Consultant    /  [log in to unmask]

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