Hi  Gabi - and welcome!

I am not surprised you couldn't wait to post that story on Lactnet - I was
overwhelmed by it....
 I am a Canadian - I have a High Risk obstetrical Nursing background ( Mt Sinai
in Toronto 85-89 and the University of Alberta Hospital, Edmonton  89-93, Royal
Columbian Hospital, New Westminster 93 - 95) - and your story of this birth
brought tears to my eyes.  This women's labour is a war story - she was induced
based upon - what -   an  ultra sound which suggested IUGR (this diagnosis has a
high falsle positive rate ) at term - sounds like that diagnosis was wrong in
spite of the placenta -  as the mother's stature is probably highly correlated
with a 6 lb baby as normal growth.  We should be grateful she didn't end up a
C/S as there is ample evidence that induction increases the C/S rate by
300%(Alberta Perinatal Research Committee, 1993) -  The cascade of interventions
which ensued this induction included:  ARM, oxytocin, epidural, continious fetal
monitoring, fetal scalp pH (x3???)  During this labour she was likely kept NPO
(not because this is good practice - I argue that it is not )  and - as is
normal custom - likely received a Lactated Ringers solution by IV - so got few
calories .  Big surprise that she would spill ketones in her urine .   BIG
mistake to give any women a bolus of sugar in labour - YES - it can cause
rebound hypoglycemia in baby after delivery - that is why large bolus of glucose
solutions  is CONTRAINDICATED.  What was her blood sugar before this bolus was
given???   Not to discontinue the reign of interventions - the baby was PULLED
out with a vacuum.  The women had an episiotomy.  The poor infant was
immediately seperated from its mother for VIGOROUS suctioning - I am indeed
surprised that the one minute APGAR was 8 - as it is my experience that the
suctioning causes such profound vagus stimulation the kids go bradycardic and
lose out (iatrogenesis take a bow). BTW - there is new evidence which suggests
that visualization of the cords and aggresive suctioning of mec babies does NOT
decrease the incidence of mec aspiration.  The babies have already filled their
lungs with the mec in utero....  another e-mail topic.

What a HORRIFIC birth story.  I went back to school to become a midwife because
I saw one two many of  these obstetrical care practices.  I would sometimes get
physically sick in response to the aggressive management of human labour and
birth.  And became even more disturbed when these women - thanked their
obstetricians and GPs profusely - after all the morbidity they suffered....they
just didn't know it could have been different....

One day I will write a book about obstetrical iatrogenesis - and publish all the
morbidity stats of all accouchers in Canada.  Let women pick their caregivers
based on the individual practitioner's  OUTCOMES.  Isn't that what consumers
magazine does?????  Can you tell I am steamed?

Our hospital policy for infants of the diabetic mother includes:  Baby stays
with mother.    Breastfeed within one hour of birth.  At one hour do  one touch
blood sugar.  If BS is above 2.0  - okay.  If BS 2.0 or below - follow decision
tree  (then goes into degree of hypoglycemia txs - mild - give another feed  1 -
breastfeed, 2. colostrum feed by cup/spoon/dropper, 3.  formula feed by
cup/spoon/dropper- repeat BS.  Mod to severe - call SCN and initiate IV
dextrose.....  )  I am not saying ours is the most progressive - I believe it is
not - but at least we 1) don't seperate mom and babe, 2) offer the breast early
and often 3) if we must supplement it is not with a bottle,  and 3) don't give
bolus infusions of dextrose solutions to women in labour...... I know of no baby
to have suffered in any way as a result of our protocol - which means to me that
your SCN has 1) not enough to do with REAL sick babies or 2) wasting alot of
their time providing a service which is not required.     I can fax you a copy
of our protocol - which is based on the British Columbia Reproductive Care
Program's Guidleines for Perinatal Care.  The BCRCP is a program of the BC
Ministry of Health and was established to set guidelines and offer outreach
programs in perinatal care in our province.  The Infant of the Diabetic Mother
protocol was authored by a team of Neonatalogists, pediatricians and clinical
nurse specialists affiliated the BC Children's Hospital and BC Women's (formerly
the GRACE).

BTW - a blood sugar of ZERO?  Was the baby dead??? Give me a break.......  What
do the NICU/SCN nurses out there have to say??????

Hang in there - two steps forward - and one baby step back.......

Kim Campbell RN BScN MN(c) IBCLC , Student Midwife (U of A)  Vancouver

"The newborn baby has only three demands.  They are warmth in the arms of its
mother, food from her breasts and security in the knowledge of her presence.
Breastfeeding satisifes all three."
Dr. Grantly Dick-Reid