Dear Marianne
After reading through the Guidelines for the prevention and management of
Hypoglycaemia of the Newborn ( WHO) , and also being disturbed by the
number of glucose exams that they required, I realized that these guidelines
are for the babies that are at high risk for hypoclycemia, and it is
mentioned specifically which babies these are . on PAGE 1 there is a section
on "Which babies are at risk" - with the explanation about babies that are
unable to mobilize energy stores through the "counter-regulation" process.
. Happy to know that healthy term babies born to healthy mothers are not in
this catagory.
If any of the hospital based IBCLCs have a protocol for the first 24 hours
after birth, that does not include testing blood glucose , I would be very
appreciative if you would send it to me. This includes , 1/ the baby did
not nurse at birth ( even with s2s) 2/ sleeps or refuses to nurse
the first 24 hours ( inspite of trying to wake the baby every few hours, ,
hours of s2s ( of course rooming in ..) 3/ and the mother does not
succeed at expressing colestrum.
Any material can be sent to me directly: [log in to unmask]
THANKS
CLOSE TO THE HEART
Leslie Wolff, IBCLC, Israel
----- Original Message -----
From: "Marianne Vanderveen-Kolkena" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, December 12, 2007 7:06 PM
Subject: Re: UNICEF UK BFI hypoglycemia policy
>
> ----- Original Message -----
> From: "Magda Sachs" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Wednesday, December 12, 2007 9:50 AM
> Subject: [LACTNET] UNICEF UK BFI hypoglycemia policy
>
>
>> Hi, this is UK information, but may be of interest to others.
>> Magda Sachs
>
> **Thank you very much, Magda, for this document! I'm gonna print and fully
> read it.
> I have a question about the flow chart, that says, after proper care at
> birth, this should be the procedure:
>
> Ongoing management to include:
> * Review (level of consciousness, tone, temperature, respiration, colour)
> * At least 3-hourly breastfeeds/EBM
> * Encourage mother to observe feeding cues
> * Further skin contact
> * Keep baby warm
> *Pre-feed blood glucose (BG) monitoring for 24-48 hours, initially prior
> to second feed then stop when level is normal x2
>
> Who can tell me some more about the last point? If all goes well, why
> should you check (how, without hurting the baby and the procedure becoming
> a traumatizing intervention?!) pre-feed blood glucose levels? I think this
> could once again be something that really interferes with normal
> biological behavior and increases medicalization of an in itself truely
> normal, steady, trustworthy process.
> Do I understand things in the wrong way...? :-s
>
> Regards,
>
> Marianne Vanderveen, Netherlands
>
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