In a message dated 8/17/98 4:59:49 PM, Loni Denman wrote:

<<  We had a baby on the unit, normal vaginal delivery, who nursed well after
birth, then didn't nurse for several hours,then nursed, then didn't. . . .
What was the appropriate thing to do here in this situation?  Increase the IV
2cc/hr to bring the blood sugar up from high 40's to low 50's or formula. >>

Hi Loni, I'm an NICU nurse in Tulsa. Several questions came to my mind:
1) Why was a normal baby who was apparently nursing in a normal fashion even
having his blood sugars checked?
2) What's wrong with a reading in the 40s? At our hospital, we have a written
hypoglycemia protocol. Any reading of 40 or above is considered okay and never
checked again (I wish babies were only checked if they were symptomatic, but
most pediatricians here do order a Glucoscan at two hours of age). Moreover, I
remember reading somewhere while studying for the exam that *30* should be
considered the low end for normal, term babies; otherwise, many healthy babies
will be (are!) needlessly treated. (I'll try to locate this reference for you
if you want.)
3) Is it common for nurses in your hospital to change IV rates as they want to
without a doctor's order? What was actually ordered for this baby, and where
was the pediatrician in all of this?

I think the appropriate thing to do in this situation was to just let mom
nurse the baby!

Jennifer Herrin RN, CBE, NICU nurse in Tulsa, OK