Dear Lactnet Friends:

I didn't see any mention of skin to skin care as a way of
preventing/treating neonatal hypoglycemia in this new policy.

And this section is confusing:

Although a laboratory determination is
the most accurate method of measuring the glucose concentration, the
results may not be available quickly
enough for rapid diagnosis of NH,
which thereby delays the initiation of
treatment.

Bedside reagent test-strip
glucose analyzers can be used if the
test is performed carefully and the clinician is aware of the limited
accuracy
of these devices. (NIKKI: SO WHY DO A TEST IF IT HAS LIMITED ACCURACY?)
 Rapid measurement
methods available at the bedside include the handheld reflectance
colorimeter and electrode methods. The
blood sample is usually obtained from
a warmed heel.

Test-strip results demonstrate a reasonable correlation with actual
plasma glucose concentrations, but
the variation from the actual level may
be as much as 10 to 20 mg/dL.

Unfortunately, this variation is greatest
at low glucose concentrations. There is
no point-of-care method that is suffi-
ciently reliable and accurate in the low
range of blood glucose to allow it to be
used as the sole method for screening
for NH. (SO WHY BOTHER WITH POINT-OF-CARE METHODS?)


warmly, and wishing that all babies (save the ones that must go to NICU)
were kept skin to skin so most of this would be avoided.
-- 
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com

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