I can hardly bring myself to mention this, but alas I must.
After having read (all right, skimmed) the WHO info at the website which was referred to on Lactnet, I wonder which symptoms (or absence thereof) the authors were referring to when discussing "asymptomatic hypoglycemia".
Is there anyone else out there in LactnetLand who has yet to see a truly low blood glucose value from a baby who got poked in the foot for being jittery?
What symptoms does YOUR unit consider indicative of hypoglycemia?
We have a couple of less experienced pediatricians who order lots of blood tests.  The one I hate the most is the fasting blood glucose, to be taken 3 hours after last feed to monitor the blood sugar in a dysmature baby (long and with a skin that is two or three sizes too large for the baby).  But when the baby, as these ones often are, is hungry every hour, if not continuously, then such a procedure, planned with the best of intentions, becomes a barrier.  Not only to breast feeding, but to good care-- a baby like this needs FOOD, not a painful stimulus to provide a number which no one is able to put into a meaningful context.
When I feel my blood sugar falling, I start to organize my next meal.  Babies do it too, but it doesn't involve going to the fridge or the pantry and making a sandwich or warming up last night's eggplant casserole.  They wake up, some cry immediately and many just start rooting and suckling or calling out to mother.  You all know this.  The only item of any possible interest in relation to a baby is how low the blood sugar is at the point when the baby starts requesting food.  I emphasize possible, because until we have a norm about which there is consensus, measuring blood suger, at least in term babies, is a waste of time, money, materials (waste disposal) and the baby's blood.
The question to ask ourselves is this: will the result of this test change the way I will care for this baby?
If the answer is no, then let Nancy Reagan be your mentor when you "Just say NO" to the test.
Rachel

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