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Hypoglycemia and breastfeeding the newborn baby

When the body uses more glucose than can be produced, the blood glucose levels will drop. This condition is called hypoglycemia. In newborn infants, this may go unnoticed at first, but in more severe cases, the baby may become lethargic, jittery, have feeding difficulties, have a rapid respiration etc. In most cases, the low blood sugar levels will be the result of delayed feedings or feedings that are not going well.

Which babies are at risk for developing neonatal hypoglycemia?

Premature or post-mature babies, babies with a low or high birth weight, small or large for gestational age babies and babies who are ill, have a larger risk of developing low blood glucose levels after birth. Also babies who are not kept warm enough may develop hypoglycemia.
When a mother had a long and difficult labor, has diabetes, has hypertension or uses certain medications, the risk of neonatal hypoglycemia in her baby is elevated.

How can hypoglycemia be treated?

A mother can try to prevent hypoglycemia in her newborn baby by latching on the baby as soon as possible after birth (the Golden Hour). The baby will get the first milk, the colostrum. Colostrum contains proteins, fats, and sugars that help stabilize the blood glucose levels in the baby. When the mother keeps the baby in her arms or on her chest, the baby will stay warm. At the same time, the mother will notice when the baby may want to nurse. Every sign of restlessness, movements with the mouth, putting hands in the mouth are signs that the baby needs to eat. During the first few days of his life, the baby may want to nurse every hour or even more often. This will maintain the the blood glucose levels. If the healthcare providers want to check the baby's blood glucose levels, ask if the baby can be tested in your room. In this way you won't lose any time while waiting for the test and the test results, but can start to feed the baby right away. By latching on really frequently, using breast compression to promote the flow of colostrum, you may prevent further treatment by supplemental bottles or glucose solutions by IV.

When is further treatment necessary?

By latching on frequently, supplementation can be prevented in most cases. When the baby is ill, premature or low-weight, it may be more difficult for the baby to stabilize the blood glucose levels by feedings at the breast. If despite frequent feedings the baby appears to have difficulties with maintaining his blood sugar levels, further treatment may be suggested. Ask if it is possible to feed the baby with a spoon, cup or syringe. In this way, the baby will not get confused by an artificial nipple and will continue to breastfeed. Also, you have a better idea of how much the baby is taking. Even when supplements are needed, the baby will probably not tolerate more than a few teaspoons.

What if the baby does not latch on?

If the baby does not want to latch on, you can start immediately to express your milk by hand, for instance in a medicine cup or on a spoon. Colostrum is only produced in small amounts that fit easily in the baby's tiny stomach. To meet the baby's need, frequent feedings are necessary, so try to latch on the baby every hour or more often if the baby is awake, or express your colostrum every hour and feed this to the baby. Once the amounts of expressed milk get larger, you can switch to a good, full-automatic, double sided breast pump to pump your milk. If you think that your baby needs extra energy even after feeding at the breast, you can also express some colostrum and feed this to the baby. In this way, you may help prevent your baby to become jittery while providing your own human milk.

If you are pregnant and think that your baby may be at a higher risk to develop hypoglycemia after birth, you can prepare yourself and discuss your early postpartum plan with a lactation consultant.

Links

Golden Hour brochure
Breastfeeding page
Breastpump rentals and sales
Breastfeeding during the holidays and special events
Breastfeeding supplies and baby carriers
Lilactation lactation consultant IBCLC
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Updated May 2012 Nanny Gortzak