Dear Dr Nair 
Thankyou for posting the protocol for screening and management of neonatal hypoglycaemia.  Your standards are quite similar to those in most hospitals I have worked in (in Australia),  
I am concerned that under these protocol many babies are unnecessarily subjected to testing, interfering with the early breastfeeding and bonding time, causing anxiety in the mother, and having a negative impact on the woman's confidence in her ability to breastfeed and nurture her child.  
For example, a large baby at term, >4 kilos (9lb) may suckle vigorously for most of the first hour of life if given the opportunity, but staff working under these protocol need to interfere when both they and the mother can see that the baby is quite well.  Many of the births which I attend in homes are of babies over 4 kilos.  Because they are infants at term, and in the absence of symptoms or other factors causing concern, there is no evidence to support blood sugar testing.  Uninterrupted skin contact and breastfeeding in the first hour are normal practices.  If a baby born at home becomes symptomatic paediatric referral is indicated.  
I wonder how many asymptomatic well babies receive milk other than their mother's under these protocol.  Do you have banked human milk?  
There has been some discussion on Lactnet recently about the new WHO book *Hypoglycaemia of the newborn - review of the literature* published 1997.  This review strongly supports minimising the intervention on babies "at risk" who are asymptomatic, and stresses that for term infants "no diagnostic blood glucose concentration can be set, [and] no reliable cotside methodology is available: reagent strip methods greatly overestimate the true frequency of hypoglycaemia in this population and are likely to lead to unnecessary investigation and treatment."

I hope that as a result of the publication of the review of the literature, and the discussion on Lactnet, hospital protocols will be changed, and practices which have a negative impact on breastfeeding