Jack and Maureen,

        How do you work with asymptomatic hypoglycemia when there are "at risk"
factors?

        Also, do you have any studies or articles that discuss the use of oral
glucose?  I plan to search MEDLINE, but anything you have handy to point me
in the right direction would be greatly appreciated.  I already have the
WHO review of Literature.

        Maureen, I would like to get in touch with your colleague who is working
on revising the hypoglycemia policy.  Please let me know if this can be
worked out.

        At my facility, a symptomatic  baby is first given ABM.  If that does not
improve the glucose with one feeding, an IV is usually started.  An
asymptomatic baby is also given ABM.

        Here is what I think the docs would have to say to me:

        (1)  We treat an asymptomatic baby to prevent worsening hypoglycemia.

        (2)  Show us the studies that indicate D10 is preferable to milk glucose.


                I thank you all for the information.  Tackling the hypoglycemia policy is
next on my list.  This has been an excellent discussion.  Thanks, too, to
the Kathys for  your work  in keeping LACTNET going!

        Donna Zitzelberger RN, BSN, IBCLC




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