Loni,

        Your's is the only post I have seen on this subject.  Please excuse me, if
this has been discussed already.  Using D10 to help a baby recover from
hypoglycemia is outdated.    D10 gives a quick sugar rush and then drops
out -- i.e. similar to eating a chocolate bar when we are hungry; our
hunger is satisfied for awhile, but it doesn't last long.  Another example,
is that orange juice used to be the quick help for a diabetic with
hypoglycemia.  Because of the quick drop out, the choice  for a diabetic
with hypoglycemia is milk.  Milk sugar lasts longer in the body system.
For this reason, the choice for improving hypoglycemia in the newborn is
the use of articficial human milk.  It is temporary -- often only one to
two feedings.   I realize that giving a newborn ABM can have long term
effects, but hypoglycemia is a major threat to homeostasis.  Treatment must
be quick and certainly does not need to involve the drastic measures of
starting an IV on a newborn. I have worked in a NICU, so I feel confident
in saying the following.   Starting an IV on a newborn is an extremely
traumatic  experience for the parents.   It creates a picture of a newborn
who is failing to survive on it's own.  It absolutely sends a message to
mom that her milk supply is insufficient; so much more so than one to two
feedings of ABM would.

I also do not agree with a newborn with an IV rooming in with mom on
postpartum.  There are too many things that can go wrong -- siblings
playing with the IV controls causing a fluid overload in baby, IVs getting
displaced, etc.  On the typical postpartum floor, one nurse is responsible
for 8-10 patients.  In a rooming in situation, that would be 4-5
mother/baby couples.  How could one nurse properly monitor an IV on a
newborn with this type of patient load?  In addition, baby is behind a door
in a postpartum room.  In the NICU, the nurse patient ratio for an infant
with an IV with hypoglycemia would be one nurse to 2 or 3 babies.  The
nurse is in an open nursery and constantly aware of the IV.

Twelve years ago, I worked for a hospital that tried to implement Newborn
IV therapy in a rooming-in situation.  The postpartum nurses did community
research and found that it absolutely is NOT a standard of care in our
community.  The plan was not implemented.

Let us not underestimate the ability of a new parent to be educated.  There
are many reasons that a newborn develops hypoglycemia.  Insufficient milk
supply is only one of them.  It is helpful to review the labor record.
Many hypoglycemic infants I have worked with have gone through difficult
labors that have sapped much of their energy.   Labor records may also
indicate  an overuse of medications, epidurals, etc.   When a new parent
has these facts explained to her, she can see that the ABM is temporary and
that the human milk supply will be sufficient to meet the baby's needs.

Hypoglycemia is one of the many situations where LC assistance keeps mom on
track; giving her the support she needs to get through a temporary setback
and go on to exclusively breastfeed her baby.

I urge you to review  and work at updating your hospital's hypoglycemia
policy.

Donna Zitzelberger, RN BSN IBCLC

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