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Newborn Hypoglycemia


Orgasmic Birth -- the documentary!

ABC's 20/20 will be airing a segment about Orgasmic Birth on May 16th for their special Mother's Day show.
Now THERE's a gift that mothers will really appreciate!

Interviews with Christiane Northrup, MD, Ina May Gaskin, MA, CPM, Sarah J Buckley, MD, Marsden Wagner, MD 

Joyous, sensuous and revolutionary, this pioneering film will compel many to reexamine their perceptions about childbirth. Viewers will understand how the use of normal, undisturbed birthing methods can aid the health and well-being of future generations.



Food for Thought - Treatment of Physiological Hypoglycemia May Be Harmful

Just-born babies have a very specialized form of nutrition.  Their bodies are designed to thrive with their predictable sequence of events after birth . . . about twenty minutes after birth (after they've mastered breathing and have initialized the visual part of the brain through gazing behavior), they follow their instinct to jump-start the production of breastmilk through suckling.  Their instincts lead them to suckle frequently and for long periods of time in the first few days to signal the mother's body that she has successfully birthed a healthy baby and that her body should continue the transition to full lactation.  Newborn bodies are perfectly adapted to thrive during this transitional period by metabolizing their specialized brown fat.  This brown fat has the amazing property that it can be metabolized directly by the brain, reducing the baby's need for blood sugar.  Thus, a lowered blood sugar level does not necessarily indicate a pathological condition; in fact, in the absence of clinical signs of hypoglycemic stress, a lowered blood sugar level may be healthy.  This non-symptomatic "hypoglycemia" should more accurately be referred to as "normal physiological neonatal hypoglycemia".

It is possible that nutritional supplementation for physiological hypoglycemia may actually be harmful to the newborn by disrupting the natural process--raising the newborn's blood sugar interrupts the newborn's metabolism of ketones and subsequent brain processes.  In particular, ketone metabolism in the newborn's brain may be part of the essential process of transitioning from intrauterine physiology to extrauterine physiology, and interference with ketone metabolism may disrupt this transition.

Those who study the production of ketones in fasting physiology know that ketones induce a noticeably different state of consciousness from glucose metabolism in the brain.  Since this is the state that the baby's body is expecting, interfering with this process may be harmful to the baby in ways we cannot guess.  These may be states of consciousness that are important in the establishment of familial bonding, learning about the environment, or other extrauterine adaptations.  We can even postulate that there is a secondary effect with disruption of ketone production that may increase the risk of autistic tendency through disruption of social bonding.

A bit of folk wisdom comes to mind - "If it ain't broke, don't fix it."  If a baby is maintaining body temperature and behaving normally, don't assume that a lower blood sugar level is an indication of a problem, and don't try to "fix it" through artificial nutritional supplementation or other unnecessary interference with the baby's metabolism.


Hypoglycaemia of the Newborn - Review of the Literature, World Health Organization, Geneva, 1997
Here is a great link. It shows BF superior to formula for hypoglycemic infants and also refutes the notion that SGA, LGA infants need to be supplemented. There is data to show that testing procedures are flawed (heel sticks) and that there isn't a good basis for setting the BS number at 40,38,35.


Neonatal hypoglycaemia-blood glucose monitoring and baby feeding

Term babies, especially those who are breast fed, are prone to low blood glucose concentrations in the first 2-3 days after birth. However, in view of their ability to generate ketone bodies, which are used as alternative fuels for the brain, it is likely that this has no clinical implication for otherwise healthy and asymptomatic babies.

Womb to World: A Metabolic Perspective by Suzanne Colson - has a great section on Neonatal Hypoglycemia


I don't do blood sugar levels, I observe for hypoglycemia by seeing if the baby is jittery, lethargic, pale, can't hold his/her temp, etc.  In the face
of a healthy baby, sugar levels are ludicrous.   If the baby is NOT doing well, O2 and 10% glucose should do the trick.  I carry 10% and 5% in my stuff.  I've used it twice.


PRACTICAL ISSUES IN MANAGEMENT OF NEONATAL HYPOGLYCEMIA


http:

5. If glucose <60 by rapid blood glucose (<40 if newborn) or unable to measure and patient is clinically hypoglycemic[3], administer:
          Neonate: 0.5-1 g/kg = 5-10 ml/kg of D10W.[4]
          Infants & children: 0.5-1 g/kg = 2-4 ml/kg of D25W or 1-2 ml/kg D50W.[3]
          Adolescents and adults: 0.5-1 g/kg = 1-2 ml/kg of D50W.


Neonatal Hypoglycemia

 




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