Wendy wrote
<I have a friend who has asked me to look into any information you might
have about low blood sugar in a newborn and mild seizure activity. We
have done a web search and found some details on medscape, but I was
looking for personal experience and advice.

Mother had c-section, baby weighed 9 pounds and has been transferred out
of the hospital where the mother remains.

One site recommended at least 5 breastfeedings in the first 24 hours,
which will be difficult to accomplish under these circumstances.>

Wendy, I may be making the wrong assumption with the information that you
supplied but it appears the low blood sugar is related to the seizure
activity. Are there any other factors involved? Prematurity?  Infant of a
diabetic mother?(Babies can have jittery movements and sometimes seizure
activity if the blood sugar level is low but there are usually pre-disposing
risk factors)  The case the baby would have had intravenous therapy
immediately put up and and an infusion of dextrose (usually 10%) should have
been commenced.  If the baby has prolonged hypoglycaemia, this places the
infant significant risk of brain damage so it is vital to get the infants
blood sugar levels up quickly and to maintain them at an adequate level.

Nevertheless (unless there are other confounding medical problems) the
mother should be able to continue to breast feed while the baby is having
intra-venous dextrose.  If it is not possible for her to be transferred to
the hospital where her baby is (or discharged to home), she will need to
start expressing immediately and regularly to maintain her milk supply and
should have her milk transported to the baby so that the IV therapy is
gradually weaned down (blood sugars permitting) as her supply builds up.
Even if only a small amount of colostrum is expressed this should be saved
and given to the baby. The ideal would be for the mother to breast feed on
demand as the IV is slowly weaned down as per the baby's blood sugar level
By the time the IV is weaned mother ideally is breastfeeding a minimum of
eight times per day.  5 feeds per day would probably be insufficient to
maintain the blood sugar levels at a reasonable level (especially as baby
already has had hypoglycaemia) and is too few feeds for a  newborn infant.

If the baby had seizure for other reasons than hypoglycaemia, the baby may
be on anti-convulsant medication and this sometimes makes the baby very
sleepy.  If this is the case special efforts should be made to fully wake
the baby up prior to feeds and ensuring attachment and sucking are adequate
and maintained.  If the baby is too sleepy initially some other means of
feeding (eg OG tube) may be needed in addition to breast feeding to ensure
the baby has an adequate quota of  fluids.
Marian Rigney RN


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