When I worked in a hospital, one of the barriers to breastfeeding that was
tough to surmount was the standard we had for checking blood sugars on
babies.  Nurses could do a blood sugar any time they thought the baby looked
questionable, and repeated blood sugar checks were REQUIRED for babies that
were below 5 pounds 8 eight ounces or above 8 pounds 8 ounces at birth.
 Feedings were also required if the results were 40 or below, and many nurses
did not interpret "feeding" as "putting the baby at the breast."  They wanted
to SEE formula or (worse) sugar water going down that baby gullet!  It was
only the occasional nurse who would get the baby to the mother for feeding
rather than give formula.  Also, nurses interpreted a result of 41, or 42, or
45.... as grounds for feeding, since they assumed that blood sugars will only
go downwards if feedings do not occur.  I could never get them to see that,
if "below 40" was considered abnormal, then "40" was normal and they could
let the baby feed when it was ready to feed.  I also believed that putting
the baby skin-to-skin would decrease stress and thus might actually allow the
baby to raise its own blood sugar without intake...but that idea was
considered too radical.

And of course, these non-helpful practices and attitudes were encouraged by
the large central nursery, where babies spent a lot of time, especially in
the first four hours after admission.  (They did get to stay with their
mothers for about an hour after birth.)

A pediatrician friend of mine is investigating blood sugar protocols in
preparation for trying to change a hospital (a different one) to a more
breastfeeding-friendly approach.  She wants to know what other institutions
are doing, especially in places where breastfeeding is better supported than
here in the Northeast.  Who can help us find answers?  Californians?  Is
anybody on Lactnet from the SIX (yaaay!) Baby-Friendly Hospitals in the USA?
 Answers from outside the USA would be interesting (and probably much more
sensible than what we have here) but might not cut much ice in a debate with
a US hospital.  Our medical jingoism is incredible!

By the way, I recommend an article from Mother Baby Journal, v 2, no 4, July
1997.  Water intoxication in a three day old: a case presentation by Valerie
Ruth-Sanchez and Carol V. Greene.  A 9 pound 8 oz baby was given so much
glucose water in the hospital that she developed seizures from hyponatremia.
 Interesting.

Looking forward to your replies.    Chris