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From:
Maureen Allen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 8 Jan 2005 14:51:53 -0500
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Kathy,
From what I know for the nurses here who took the STABLE program was that it was (they felt) geared to Level II nursery nurses who needed to be able to know how to get a baby stabilized and ready for transport to a Level III facility.  They did think the information overall was good.
Our hypoglycemia policy for NICU and for newborn nursery  (two separate policies) were changed in the past few years.  The cutoff for hypoglycemia in the normal newborn was set at 50.  I really doubt that the neos would go by the STABLE program's guidelines--I am sure that they have based this on some new research that has been done.  But, the difference is that our babies who have blood sugars under 50 are encouraged BY POLICY to go to breast times two effective feeds to get their blood sugar up.  It is felt that if two effective feeds don't get the blood sugar up, then baby may need an IV, septic workup or closer observation.  On a practical note, I have to agree.  Persistent hypoglycemia is a symptom of sepsis and of some cardiac problems (I believe one of the is hypoplastic left heart).  Even though we'd like to think it could be true, these things can't be treated by breastfeeding alone.  Although breastfeeding is protected by this policy, I believe that many babies are bottled formula because the parents or nurses "just want to fix it", or the L and D nurse can't spend the time always to ensure a good feed in a primpip, who isn't experienced yet.  But that's another topic and post.
Look further and ask the docs.  They may actually have the info you're looking for.
Good luck!
Maureen Allen RN, BSN, IBCLC
Brigham and Women's Hospital
Boston, MA

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