Dear Friends:
    The Committee on Fetus and Newborn, American Academy of Pediatrics.
"Routine Evaluation of Blood Pressure, Hematocrit and Glucose in Newborns"
was published in Pediatrics 1993; 92(3):474-476. There is nothing to support
routine measurement of any of these physical signs.
    Babies at risk is another matter, of course. Babies at risk for
hypoglycemia are those whose mothers have IDDM, are SGA or LGA or IUGR,
asphyxiated, discordant twins, have RDS, are premature, have
Beckwith-Wiedenmann syndrome, sepsis, or cold stress.  This is from a
presentation that Joan Meek, MD FAAP did on hypoglycemia at the International
Conference in Orlando, Florida.
    There are no absolute numbers for serum glucose levels in the newborn.
What numbers we use now depend on the age of the newborn, in hours. In the
first 1-2 hours of life, the FBS drops in an unfed infant; in the term,
healthy infant, the levels begin to rise by 6 hours of age. Remember that the
Accu-check is only a screening device, whose results must be confirmed by
laboratory diagnosis.
    Easiest thing is to get baby to breast within the first hour. Marshall
Klaus said that only 5-8% of babies will nurse right after birth; most will
attach at around an hour of age.
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CSTP, CIMI
Elkins Park (a suburb of Philadelphia, Pennsylvania,  northeastern USA)

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