Hi Gabi - and welcome! I am not surprised you couldn't wait to post that story on Lactnet - I was overwhelmed by it.... I am a Canadian - I have a High Risk obstetrical Nursing background ( Mt Sinai in Toronto 85-89 and the University of Alberta Hospital, Edmonton 89-93, Royal Columbian Hospital, New Westminster 93 - 95) - and your story of this birth brought tears to my eyes. This women's labour is a war story - she was induced based upon - what - an ultra sound which suggested IUGR (this diagnosis has a high falsle positive rate ) at term - sounds like that diagnosis was wrong in spite of the placenta - as the mother's stature is probably highly correlated with a 6 lb baby as normal growth. We should be grateful she didn't end up a C/S as there is ample evidence that induction increases the C/S rate by 300%(Alberta Perinatal Research Committee, 1993) - The cascade of interventions which ensued this induction included: ARM, oxytocin, epidural, continious fetal monitoring, fetal scalp pH (x3???) During this labour she was likely kept NPO (not because this is good practice - I argue that it is not ) and - as is normal custom - likely received a Lactated Ringers solution by IV - so got few calories . Big surprise that she would spill ketones in her urine . BIG mistake to give any women a bolus of sugar in labour - YES - it can cause rebound hypoglycemia in baby after delivery - that is why large bolus of glucose solutions is CONTRAINDICATED. What was her blood sugar before this bolus was given??? Not to discontinue the reign of interventions - the baby was PULLED out with a vacuum. The women had an episiotomy. The poor infant was immediately seperated from its mother for VIGOROUS suctioning - I am indeed surprised that the one minute APGAR was 8 - as it is my experience that the suctioning causes such profound vagus stimulation the kids go bradycardic and lose out (iatrogenesis take a bow). BTW - there is new evidence which suggests that visualization of the cords and aggresive suctioning of mec babies does NOT decrease the incidence of mec aspiration. The babies have already filled their lungs with the mec in utero.... another e-mail topic. What a HORRIFIC birth story. I went back to school to become a midwife because I saw one two many of these obstetrical care practices. I would sometimes get physically sick in response to the aggressive management of human labour and birth. And became even more disturbed when these women - thanked their obstetricians and GPs profusely - after all the morbidity they suffered....they just didn't know it could have been different.... One day I will write a book about obstetrical iatrogenesis - and publish all the morbidity stats of all accouchers in Canada. Let women pick their caregivers based on the individual practitioner's OUTCOMES. Isn't that what consumers magazine does????? Can you tell I am steamed? Our hospital policy for infants of the diabetic mother includes: Baby stays with mother. Breastfeed within one hour of birth. At one hour do one touch blood sugar. If BS is above 2.0 - okay. If BS 2.0 or below - follow decision tree (then goes into degree of hypoglycemia txs - mild - give another feed 1 - breastfeed, 2. colostrum feed by cup/spoon/dropper, 3. formula feed by cup/spoon/dropper- repeat BS. Mod to severe - call SCN and initiate IV dextrose..... ) I am not saying ours is the most progressive - I believe it is not - but at least we 1) don't seperate mom and babe, 2) offer the breast early and often 3) if we must supplement it is not with a bottle, and 3) don't give bolus infusions of dextrose solutions to women in labour...... I know of no baby to have suffered in any way as a result of our protocol - which means to me that your SCN has 1) not enough to do with REAL sick babies or 2) wasting alot of their time providing a service which is not required. I can fax you a copy of our protocol - which is based on the British Columbia Reproductive Care Program's Guidleines for Perinatal Care. The BCRCP is a program of the BC Ministry of Health and was established to set guidelines and offer outreach programs in perinatal care in our province. The Infant of the Diabetic Mother protocol was authored by a team of Neonatalogists, pediatricians and clinical nurse specialists affiliated the BC Children's Hospital and BC Women's (formerly the GRACE). BTW - a blood sugar of ZERO? Was the baby dead??? Give me a break....... What do the NICU/SCN nurses out there have to say?????? Hang in there - two steps forward - and one baby step back....... Kim Campbell RN BScN MN(c) IBCLC , Student Midwife (U of A) Vancouver "The newborn baby has only three demands. They are warmth in the arms of its mother, food from her breasts and security in the knowledge of her presence. Breastfeeding satisifes all three." Dr. Grantly Dick-Reid