What are you defining as 'late preterm'? (see table below)
Totally agree that keeping mothers and babies together and leaving them
alone is the best way to prevent all sorts of separation-related problems
(regardless of the baby's age), including low glucose levels. All the
information below is from BAMS (I can't recommend this book enough - if you
don't already have it, get it).
Ingrid
Ingrid Tilstra
La Leche League Canada Leader
International Board Certified Lactation Consultant
This table from page 259 of Breastfeeding Answers Made Simple includes
guidelines for babies born from 34 weeks:
Baby's status Baby's age in hours Glucose levels indicating need for
treatment
Born 34-40 weeks <24 hours <30-35 mg/dL
No symptoms
Healthy >24 hours <40-50 mg/dL
Taking milk feedings
No risk factors
Symptoms Any age <45 mg/dL
Illness or birth-related issues <24 hours <45-50 mg/dL
Low birthweight >24 hours <40-50 mg/dL
Preterm
Respiratory distress or failure
Sepsis (blood infection)
At risk Any age <36 mg/dL
Diabetic mother
Glucose IV in labour
Sepsis
Small-for-gestational age
Oxygen deprivation
Metabolic disorder
Endocrine disorder
Low blood-glucose levels Any age Start IV glucose treatment and
monitor
<20-25 mg/dL
Infants receiving ONLY human milk have naturally lower blood-glucose levels
than infants receiving artificial substitutes.
Separation of mother and baby leads to lower infant body temperature
(Bystrova et al., 2007), one risk factor for hypoglycemia. Skin-to-skin
contact has been found to be more effective than incubators at maintaining
newborn body temperature, even among preterm babies (Bergman, Linley, &
Fawcus, 2004). One Swedish study found that babies separated from their
mothers cried 10 times more, had elevated cortisol (a stress hormone), and
blood-sugar levels, on average, 10 mg/dL lower than babies kept in
skin-to-skin contact (Christensson et al., 1992).
Specific postpartum practices that can reduce the risk of hypoglycemia
include:
- in the hours after birth, keep mother and baby in skin-to-skin contact and
together day and night (Bystrova et al., 2007; Suman, Udani, & Nanavati,
2008)
- encourage frequent body contact to trigger inborn breastfeeding behaviours
and early and frequent feedings (Colson, DeRooy, & Hawdon, 2003)
- respond quickly to a baby's earliest signs of hunger before crying starts;
the stress of crying decreases blood-sugar levels (Christensson et al.,
1992)
- if a baby is not breastfeeding at least every 2 hours or so, suggest the
mother express a little colostrum into a spoon and feed it to the baby
(Walker, 2006)
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