I second the suggestion to check the WHO publications and the Academy of BF
Medicine protocol. There are so many things to consider, and I feel sorry
for any LC who is trying to educate others on this topic. Hopefully, it will
result in protection of bf and better care for moms/babies. Some things to
consider: which babies really need to be monitored for this? Not all do.
What is the cutoff value for normal vs abnormal glucose readings? 30, 40,
50? What laboratory methods are used vs bedside SCREENING are used?

I appreciate Barbara's citation of the study comparing infants who received
prelacteal glucose water vs bf only. I don't think this can be generalized
to the non-latching baby, though. Things are so different with the
non-latching baby. Is he overmedicated, and can that have an effect on his
glucose metabolism? Was his birth more difficult? Is he separated from his
mother? Is he receiving any skin to skin contact?

I don't know if there is any specific quantity that could be prescribed. I
would have the mother express frequently, every 1 to 2 hrs, and spoonfeed it
to the baby. I would keep the baby and mother skin to skin, kangaroo style.
Colostrum has protein that is better at stabilizing the glucose than sugar.
Also I realize the 'average' 24hr amount of colostrum has been cited at 14 -
30 cc's but I have seen moms express 30cc several times a day, and I have
seen moms unable to express anything for 8 days! (I guess that gives us the
'average'). If the babies have hypoglycemia or are at risk for same, then
the blood sugars are being monitored, right? I guess this will tell you if
the amount is enough. Good luck with this challenge.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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