First I offer my thanks to Genevieve Colvin for the link to that  webinar.
I make much of that information available to my clients when we talk about
immediate post partum protocols.what exactly will the staff want to do to
their baby and why.  

  

Using the info in that webinar, (  http://paclac.org/webinars/ ), a
California  group, the Perinatal Advisory Council developed a protocol for
dosing the suspect newborn with sugar  gel plus formula basing the feeds on
how much of each brought sugars up, but the amounts of formula are
arbitrary.  For example, by experimenting with amounts, they found that 1
gel treatment plus 20 ml of formula brought sugar up x amount, etc, in some
babies of a certain risk,  but some babies would only take 10 ml. and some
babies need 3 gel treatments, and X amount of formula.

 

The title of the webinar is  "Neonatal Hypoglycemia: Bridging Evolving
Evidence and Recommendations to Improve Newborn Care", and it is a
monumental  effort, so you can see that the "hard evidence" you need doesn't
seem to exist   to determine exact feed amounts,  or this thorough
examination of feeding for LBS would have it. The key word about this kind
of evidence is that it's evolving!  Nikki's valuable advice that lots of s2s
regulates BS must become part of hospital protocols.   Any mother who wishes
exclusive breast feeding is more than willing to collect colostrum ad lib to
help her baby avoid any LBS sequelae.  We need to teach good hand
expression, rather than rely on formula as the go to "fast food"  for
newborns.  What will that hospital do if a mother refuses formula?  No
studies yet have contradicted the ABM Protocol #1 about  LBS.  Not talking
about a sick baby or a symptomatic baby, just the fact that treating for
risk categories treats many babies who don't need it. Families will gladly
submit to a gel-cum-formula protocol to help their babies, so why no
protocol with the same power to have parents  do s2s and if they can't yet
nurse, collection and feeding of colostrum as a must.

 

Formula changes a baby's gut, causes micropscopic bleeds at interstices.
That's what studies show.  Who is weighing the harms to the gut against the
transitory normal low glucose state of the asymptomatic baby. Again, I don't
presume that you all don't know this stuff.

 

Have a jolly 4th and a fine summer!

Jackie Levine

 

 


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