In a message dated 95-09-29 18:07:07 EDT, Ruth Sweet wrote:

>I am concerned that we now seem to be using an infant's blood glucose level
>to justify interventions that interrupt breastfeeding in much the same
>manner that we used to use ac/pc (before feed/after feed) weights with the
>old barely accurate scales.
>
>Unless a tube of blood is analyzed in a lab, we do not have any way of
>knowing an infant's true blood glucose.  The meters used by people with
>diabetes are not designed to be used for neonates.  High hemoglobin causes
>the strips and meters to give a glucose value lower than it actually is.

This is true and is the reason we no longer use the meters in the NBN.  Our
lab must come and draw a specimen.  The problem then is that it takes some
time to get the results, and if the infant is very symptomatic, it isn't
always wise to wait. (We're talking potential brain damage here.)  If the
baby won't nurse at breast, formula is the only alternative, but we usually
try BF first..

>A second problem, is that user technique can greatly effect the result.
>When the same meter is always used by the same person, we can be fairly sure
>that the results will be usable.  e.g. a 120 result might actually be 100 or
>140, and a 180 might actually be 150 or 200, but we know that the 120 is
>always lower.  We cannot come to the same conculsions when we look at
>results done by many different operators in a Hosp. Nursery.

Our institution requires that every nurse run a test on "mystery serum"
several times a year.  Results must fall within acceptable limits or the
nurse cannot continue to run blood sugars until she has cleaned up her
technique.  Also, controls are run on each meter on every shift to ensure
it's functioning properly.

>I questioned each of the
>companies, and none of them claimed to be able to give accurate results
>for neonates.

True again, but one of the nurses on our unit, who has a strong interest in
diabetes, is preparing to do a study with a new meter (I can't remember the
name, but I'll ask her about it) which, according to the manufacturer, is
supposed to be accurate for neonates.  I have high hopes that we'll again be
able to run specimens ourselves and get accurate results immediately, which
will help to eliminate the unnecessary formula feeds.

Judy D in WV