I have relied heavily on the referenced info in BFG & HUMAN LACTATION which suggests that 30mg should be the minimum for the first day of life rather than 40. Especially noteworthy is the comment that glucose serum levels will rise on their own during the first day, even without additional feedings! Putting baby to breast early and frequently is usually sufficient. I think that it is important to also screen for risk factors, such as maternal diabetes, maternal glucose IV during labor, extreme infant lethargy and the other related signs, as these can add valuable information in determining true problems. I have unfortunately seen the panic button pushed in my community for babies who had no risk factors and appeared normal and healthy but displayed a few occasional tremors (including just after a circ!) with glucose readings of just under 40mg. I concur with the referenced researchers who suggest that maybe we need to redraw the "accepted guidelines", as otherwise fully 25% of newborns are going to be considered sub-normal. While we do have many labor management practices (ie no food during labor) that can legitimately cause some of these crises, I have a hard time believing that nature otherwise messes up so often. -Lisa ****************************************************************************** Lisa A. Marasco, IBCLC / [log in to unmask] International Board Certified Lactation Consultant / [log in to unmask] ******************************************************************************