Dr Jack said: " ... a baby does not really become "dehydrated" after 36
hours....All this baby needed was a little extra colostrum dissolved in
sugar water, or just plain sugar water (given by lactation
aid) and the acute crisis would have been over...."

In my heart I want to agree with minimal intervention but I have to play
devil's advocate here.   So....in the spirit of becoming effective change
agents .... and at the risk of nit-picking ....

1) If the baby is not dehydrated why does he need water?
2) Why if nothing is wrong and the baby is not dehydrated does he have a
temperature elevation.   Frequently in the same type scenario I see elevated
respiratory and heart rates also.
3) Why do we see these changes
4) Why do you recommend sugar water and
5) are you concerned about glucose rebounding down after getting just sugar
water?
6) How do you feel about the recent article that strongly states babies
under one month should not have plain water?   Prior to the publication of
these precautions I would slip a little water via a supplementing device at
the breast to babies in similar cases.  Now I am leery of doing so.

Toni said "Glucose (obtained earlier) was 60. Sodium was described as "high"
to me by the LC." and that "Three wet diapers were recorded in the previous
9 hours, along with one stool"

7) If the baby is dry, why is it urinating in seemingly sufficient
frequencies.
8) Should we be looking at the specific gravities of the urine in suspect
babies?
9) if so, what will that tell us.  What should it be, when do we worry?
10)  Why, if the baby is not getting enough does it have such a good looking
glucose level?
11) why are these babies so fussy?  Often in similar scenarios I see babies
who willingly start to nurse (at times frantically) with a good attachment
but shortly come off screaming, other times I see babies like Toni described
who are happy while at the breast but frantic when off even after what
seemed to be an effective feeding.
12) Why is the sodium "high"?
13) Could this baby have over urinated because of labor and delivery
factors, in essence let go of fluids that were still needed?

We have had it drilled into our heads over the last few years that a baby
who needs supplementation needs a full food - fluid, carbohydrates,
proteins, fats.... preferably breastmilk but if that is not available then
formula.  How do you counter this argument?

Our first rule is feed the baby.  How do you know when it is time to give
formula, what are your criteria?

Carla D'Anna