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Low Sugar in the Blood
What Does It Mean for Your Breastfeeding Baby? By Ann Calandro
It is not good for babies to remain hypoglycemic. The most devastating effect would be seizures and brain damage. Therefore, hospitals have guidelines for testing newborns for low blood sugar. Hospitals may follow differing guidelines and protocols for checking blood sugars.
Some methods of checking are more accurate than others. The Committee on Fetus and Newborn of the American Academy of Pediatrics states that "...no study has shown that the treatment of a transient low blood glucose level offers a better short-term or long-term outcome than the outcome resulting with no treatment ... Furthermore, there is no evidence that asymptomatic hypoglycemic infants will benefit from treatment."
However, there is a good bit of controversy about this statement from some medical experts who feel that it is important to treat hypoglycemia early, even if Baby is without symptoms. What would be symptoms of low blood sugar? According to the Academy of Breastfeeding Medicine, some of these symptoms are tremors, irritability, high-pitched cry, seizures, lethargy, rapid breathing, cyanosis and refusal to feed.
Babies thought to be more at risk are those with diabetic mothers and those who were premature babies, small for gestational age babies, a smaller twin and those who were subject to cold stress, respiratory distress or polycythemia (thick blood). After birth, hypoglycemia is more prevalent in babies whose mothers had long labors, anesthesia, dextrose-only IV fluid and/or were not allowed to eat. Babies who have been stressed during delivery, have gotten too cold and have been separated from skin-to-skin contact with the mother are also at higher risk.
Breast milk may be expressed and fed to the baby if necessary. Donor breast milk or formula may be used if mother's own milk is not available. Feeding the baby glucose water is not recommended. If the baby is unwilling to suck, the Academy of Breastfeeding Medicine protocols state that it would be risky to try and feed the baby, but instead, intravenous glucose treatment should be started. Glucose IV fluid should always be started on babies whose glucose level is lower than 25 mg/dl.
After birth, babies must be kept warm, held skin to skin if possible and breastfed on cue in order to facilitate a normal increase in blood sugar levels. Mothers need to know that by planning on feeding in the delivery room, they can help prevent this problem for their newborn baby. Babies should not be left to cry, either in the nursery or the parent's room. Prolonged crying decreases blood sugars.
If your baby has low blood sugar, ask your physician if you can keep your baby close and feed him frequently. If he is not interested in sucking at the breast but is alert, you can hand express or pump out a teaspoon or two of colostrum and feed him with a small syringe, cup or spoon. Experienced nurses marvel at how just a small amount of colostrum can greatly increase Baby's blood sugar. If colostrum or donor milk is not available, the baby may need a little formula. Supplements of any kind do not have to be fed with a bottle. They can be fed with a small syringe, cup or spoon. The nurses will continue to monitor your baby's blood sugar until it stabilizes.
Once the sugar is controlled and feeding is established, low blood sugar is no longer a problem in normal healthy babies. If the low blood sugars continue, other health problems must be ruled out.
According to information shared at a health care conference by Dr. Jay P. Goldsmith, M.D., FAAP, "Most hypoglycemia is over diagnosed, over treated and does not cause brain damage." However, health care providers, as with all possible complications concerning infant health and liability issues, must be unfailingly vigilant in their newborn observations and care in order that the rare symptomatic hypoglycemia is treated without delay.
