Cindy and Anna at Sioux Valley Hospital asked about hospital protocols and
breastfeeding when sugar levels are low.  The physician's standing orders for
breastfeeding where I work state that infant is to be breastfeed if level is
<40.  IF level is <20, infant is to be fed commercial baby milk and doc is to be
called.

Even with such orders in place, we see inappropriate care -- babies fed 5%
water, mix of commercial baby milk and 5% water, bottle when level at 35 or 40,
etc.  These standing orders have been approved and in place for all of our docs
for 2-3 years.  Change is slow.

IF one of the IBCLCs is involved with the mother/baby in question at the
appropriate time, mother may be pumped if infant not feeding and the expressed
early milk fed by small, sterile, silicone dropper or cup to infant.  IF we are
not there, anything goes!!

Pardee Hinson
Mercy Lactation Support Center
Charlotte, NC