Newborn Sugar Levels and Breastfeeding

There are certain conditions where a newborn’s risk of hypoglycemia increases. What are those conditions? How and when are they tested for? If there’s a concern, does that mean your baby will get formula supplementation, and how does all of this impact initial breastfeeding? Dr. Casey Rosen-Carole has answers. Check it out.

What we talked about:

• Why do we care about sugar levels?
• Are sugar levels a good indicator of impaired metabolic adaptation?
• What causes hypoglycemia? What is the % of babies that have it?
• If sugar levels are low, what is the risk for neurological damage? Does the body not have any protective mechanisms against this?
• Hypoglycemic newborn signs or symptoms
• The evidence for treatment
• What infants are at risk?
• Do healthy, full-term babies born to people who experienced a normal pregnancy, labor, and birth need to be tested?
• How are babies tested?
• Is there a threshold for what number constitutes low blood glucose levels?
• Normal drops in levels vs. concerning levels
• Protocols/options for helping the stabilization of sugar levels
• Glucose gel, formula, IV glucose or expressed milk?
• How do these interventions (glucose, formula supplementation, separation) impact breastfeeding?
• What can new parents do to help encourage breastfeeding with these interventions?
• Can you do anything during pregnancy to lessen the risk?
• What about preemptive expressing of colostrum?

Related resources*:

• Postnatal Glucose Homeostasis in Late-Preterm and Term Infants, from the American Academy of Pediatrics
• Guidelines on neonatal hypoglycemia, from baby gooroo
• Hypoglycæmia of the Newborn (Low blood sugar), from the International Breastfeeding Centre
• New approaches to management of neonatal hypoglycemia, from the Maternal Health, Neonatology and Perinatology journal
• Implementing a Protocol Using Glucose Gel to Treat Neonatal Hypoglycemia, from the Nursing for Women’s Health journal
• ABM Clinical Protocol #1: Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates, Revised 2014, from The Academy of Breastfeeding Medicine
• Early neonatal hypoglycemia: incidence of and risk factors. A cohort study using universal point of care screening, from the Journal of Maternal Fetal Neonatal Medicine
• ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. (pdf download)
• UR Medicine Breastfeeding website
• Resources on navigating the NICU, including a great handout on hand expression, from UR Medicine Breastfeeding (handouts are downloadable .pdfs)
• Hand Expression of Breastmilk, video from the Stanford School of Medicine

Related Birthful episodes:

• Gestational Diabetes, with Lily Nichols
• Low Milk Supply, with Diana Cassar-Uhl
• Breastfeeding your Newborn, with Dr. Jack Newman
• The Baby’s Birth Experience, with Karen Strange
• Navigating the NICU, with Sue Hall

Courtesy of Dr. Rosen-Carole

About Dr. Casey Rosen-Carole

Dr. Rosen-Carole is Medical Director of Lactation Services and Programs at the University of Rochester. She trained at New York Medical College and completed a residency in Pediatrics at Yale New Haven Children’s Hospital. She was a practicing community pediatrician and residency faculty from 2008-2014, in New Haven, CT then in New York’s Hudson Valley before relocating to Rochester to do a fellowship in Breastfeeding Medicine and General Academic Pediatrics. Dr. Rosen-Carole was in the National Health Service Corps from 2010-2014 working in Federally Qualifying Health Centers, which helped her fulfill her mission of increasing access and quality of care for at-risk children. She practices outpatient and inpatient Breastfeeding Medicine.

Dr. Rosen-Carole’s research focus is in systems change for breastfeeding education and support; she is currently investigating the role of stress in mothers whose infants are admitted to the NICU. Other areas of interest include community organizing to address social determinants of health, programming for diversity and equity.

UR Medicine Breastfeeding – Call (585) 276-MILK
MotherToBaby – Call (585) 275-3638 or 1 (844) 352-3420 (toll-free) or email MotherToBaby@urmc.rochester.edu (9:00am to 4:00pm Monday through Friday).