I need some input on the subject of hypoglycemia.  I work as a Lactation
Consultant in the metropolitan Detroit area in a hospital that does
approximately 3500 births a year.  The majority of births are what I would
call managed in that very few women seem to go into active labor on their
own, with frequent inductions at 38-39 weeks for a variety of reasons as
well as pitocin stimulation during labor after the epidural.  We have a
Csection rate of approximately 30%.  I am very frustrated trying to practice
as a Lactation Consultant in this setting because the end result for these
poor moms and babies is difficulties well past discharge.  I'm sure many of
you share my frustration with the current state of affairs in the hospital
setting.  The most recent problem that has surfaced is the issue of blood
sugars.  We are now being told by our neonatologist that any blood sugar
below 40 means an immediate formula feeding without first trying to bring
the baby's blood sugar up with breastfeeding and skin to skin contact to
warm up the baby. This is the recommendation no matter what the cause of the
low blood sugar.  I am looking for references and info to support putting
the baby to breast and skin to skin contact to bring up the blood sugar as
opposed to automatically feeding formula.  I already have the WHO guidelines
on Hypoglycemia as well as the info from Lawrence's and Auerbach and
Riordan's books.  I also know that ILCA has a new module related to this
subject which will be coming out soon but I need some info that I can use
now until I can get my hands on this module.  I'm going to be attending a
staff meeting on October 31 to discuss this issue so would appreciate any
help you can give me.
Sharon Kraft, RN, IBCLC
Sylvan Lake, MI





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