Whether your baby is preterm, large for gestational age, small for gestational age, just having a rough transition outside the womb or if you are diabetic (any type), your baby’s blood sugar will probably be tested. This is most often tested via a simple heel stick at the bedside with a glucose meter.
Four out of five of my babies were big. They were all considered “large for gestational age” so they all went through this torture. But I’m pretty sure it was more tortuous for me because I didn’t really understand why this was necessary and I was already super on edge and not trusting of the staff. I want you to know all the facts ahead of time and have the tools to deal with it if you have to.
While the American Academy of Pediatrics has guidelines on blood sugar in newborns, most hospitals differ slightly on their exact policies. Whatever the policy is and wherever the thresholds are set, the goal is to keep your baby’s blood sugar above it. If he falls below, steps need to be taken to help your baby get above the threshold. (The nurse will tell you the goal number when she does the heel stick.)
Here are steps to help keep your baby’s blood sugar normal when breastfeeding:
- Skin-to-skin: This is one of the best ways to help normalize the blood sugar and keep baby’s temperature stable. This is accomplished when the baby’s naked chest is against his mother’s naked chest. Time is important with skin-to-skin: the longer the better. Also, doing skin-to-skin for at least half an hour after breastfeeding helps to normalize blood sugar. (Skin-to-skin works with dad, too!)(Great video on skin-to-skin.) This is an awesome tool for skin-to-skin:
- Feeding: The preferred feeding method is with mother’s own milk first, whether this is directly at the breast or feeding expressed breastmilk. Sometimes the baby is not feeding well enough or the volume isn’t sufficient to stabilize the blood sugar, so a supplementary feeding is necessary. This can be donor breastmilk or formula.
- Glucose Therapy: If feeding the baby is not sufficient, supplementary glucose may be used to stabilize his blood sugar. This is often given via IV, but some hospitals now have oral glucose gel for this purpose. In either case, oral feeding needs to continue because the protein in the milk is important to help prevent a blood sugar crash following a dose of glucose.
So, what can you do?
If your baby is not feeding well, or supplementary feeds are needed, you should begin expressing your milk. This can be accomplished with hand expression, pumping, or a combination of both. Work with the lactation consultant to ensure you are maximizing your milk output.
For mothers who are diabetic (any type) and are not at risk for preterm labor, beginning hand expression a few weeks before delivery will result in small amounts of colostrum that can be stored and brought to the hospital at delivery. This can be used if supplementation becomes necessary. Click here to read about hand expression.
Why blood sugar is tested:
- diabetic mother
- large for gestational age
- small for gestational age
- rough transition after delivery
How blood sugar is treated:
- skin-to-skin (Watch this video on skin-to-skin.)
- glucose therapy
What can you do:
- hand express
- work with a lactation consultant