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Date: Fri, 21 Apr 1995 15:15:56 -0700 (PDT)
From: Elizabeth Williams <[log in to unmask]>
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Kathleen, why isn't this deliverable? Thanks for your help. --Beth Williams

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Date: Fri, 21 Apr 1995 14:58:44 -0700 (PDT)
From: Elizabeth Williams <[log in to unmask]>
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Subject: hypoglycemia (fwd)
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Date: Fri, 21 Apr 1995 14:55:48 -0700 (PDT)
From: Elizabeth Williams <[log in to unmask]>
To: [log in to unmask]
Cc: [log in to unmask]
Subject: hypoglycemia


The American Academy of Pediatrics' Committee on Fetus and Newborn issued
a statement on Routine Evaluation of Blood Pressure, Hematocrit, and
Glucose in Newborns in 1993, published in Pediatrics (92:474-476), which
noted: "Even if a glucose level of 30 mg/dl is ued as a cutoff value for
hypglycemia in full-term infants, the reported incidence of hypoglycemia
varies from 0.4% to 11.4%%. Risk factors for the development of
hypoglycemia have been described. However, in one study 72% of 232
infants were found to have one or more of these risk factors. None of the
infants w/out the risk factors had hypoglycemia (defined as a blood
glucose value, measure by Dextrostix, of less than 40 mg/dL); of those
with at least one risk factor, 28.6% had hypoglycemia."

Of course, I doubt that any of the studies to date have assessed the prevalence in a
population where immediate breastfeeding is the norm.
The point is well taken that "no study has shown that treatment of a
transient low
blood glucose level offers a better short-term or long-term outcome than
the outcome resulting with not treatment."
The Committee's recommendation was "universal neonatal screening for
hypoglycemia is not warranted in most nurseries. Selective screening for
high-risk babies ---may offer an advantage over universal screening;
however, in those nurseries where a large proportion of infants fall into
one of the high risk categories, it may be easier to screen all infants.
The question of the appropriate age for selective screening still needs
to be answered."
Elizabeth Williams, MD, MPH
Stanford Univ. School of Medicine
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