It never ceases to amaze me that when breastfeeding is the issue all evidenced based practice goes out the window.  The AAP Committee on Fetus and Newborn and the Academy of Breastfeeding Medicine have protocols based on sound rationale:
    "No study has shown that treatment of transient low blood glucose level offers a better short-term or long term outcome than the outcome resulting with no treatment. "  There is no evidence  that asymptomatic hypoglycemic infants will benefit from treatment."
AAP, Pediatrics, 92(3): 474-76.

    The ABM gives a definition of hypoglycemia with levels of lower limits at various hours after birth, risk categories, and management of asymptomatic and symptomatic infants. 
The Academy of Breastfeeding Medicine, Guidelines for glucose monitoring and treatment of hypoglycemia in term breastfed neonates.(Can be found on their website)

The World Health Organization also has an extensive paper on this subject with 10 pages of references!(Can find on their website.)
    Most babies if put skin to skin as much as possible will feed. If people are uncomfortable about the 
baby not feeding, why not help the mom pump colostrum and feed by spoon or cup. Colostrum is a much better stabilizer of blood sugar than glucose water. Glucose water does nothing to stabilize blood sugar and may cause rebound low bs. Giving formula puts the baby at risk for CMP allergy...unless you use a protein hydrosylate formula. 

The major problem is that we do not know what normal blood sugar is for a newborns in the first few hours and days of life!  If breastfed babies were the norm and all studies were based on breastfed babies, what would normal blood sugar be????
Carol L'Esperance RN, MSN, IBCLC

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