I was presented with a mom Gravida 3 who had this baby C/S for breech
position.  The baby went to the transitional nursery for mild
respiratory distress (TTN).  She was on oxygen for 12 hours and made NPO
on a D10W infusion until resp. distress got better and sepsis workup was
complete.  Her culture have been negative for 24 hours.  Cbc was not
shifted, so infection was ruled out.  Her dextrose infusion was stopped
at 20 hours of life and mom put baby to breast immediately following
(she is an experienced breastfeeder and baby latched right on).  The
nurses carrying for mom and baby were concerned becausue the baby was
sleepy (but nursing well) and looked "skinning with decreased tone" and
consulted the lactatin team.  Upon my exam, baby's mucous membranse were
moist, tone was okay, she was nursing well, wet diapers and soiled
diapers were good.  I gave the mom reassurnce that everything seems to
be fine, and that we will watch the baby closely and wait patiently for
her mature milk to come in.  Our hospital policy is not to check routine
d-sticks.

My question is after the baby has recieved a continous D10W infusion for
a long period of time and then it is withdrawn for breastfeeding to a
breast just producing colostrum, shouldn't we be concern about the
baby's glucose hemostasis?  I never really thought about this before
from a physiological perspective until now.  Anyone have any thoughts on
this?

Please email me privately as am having difficulty keeping up with the
LACTNET digests!

Thanks in advance!

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