4 week prem, blood sugars and bf.

[TittyBojangles]

My friend has just had her DD, 4 weeks prem, but a good weight of 6lb7. Her blood sugars are a bit low, though feeding seems to have been going well so far. They have told her she needs to leave an hour between feeds (something to do with them checking her DD - maybe her sugars?). Does this sound right? Why would she need to leave an hour between feeds? Her DD is with her i.e. not in scbu or anything so theoretically I guess she could feed when she likes. She is so keen to successfully bf and I am trying to be helpful, don't want to give her any crap advice. Any experiences of this would be great, thanks.

Could she ask to have a chat with her favourite duty MW when she gets 5 minutes and ask her to go through it all again with her.

There's so much info thrown at you when you first have a babe!

They probably want to make sure baby has little & often as she's prem, rather than a big guzzle then sleep for a few hours, but best to check what they're really wanting to achieve.

Congrats to your friend that's a good weight for a prem!

My dd was born at 36 weeks (5.7) and low blood sugars. I wasn't told to leave an hour between feeds, but then she wasn't latching anyway so i was hand expressing and syringe feeding colostrum. IIRC the blood sugar test was the quick prick in the foot so no specialist test.

Hope someone with better knowledge as to why this might be can come and help you

Thanks for the advice so far. It IS a great weight! I had told her little and often, lots of skin to skin etc. She said most of the mws have been great, I think there was just one who has been a bit of a pita and upset her. But she says shes just done a good feed and hoping to go home tomorrow so sounds like things are going ok. Just trying to head off any problems before they arise so I know what to tell her. I have told her to speak to one of the nice mws about it and to double check any bizarre advice she is given.

Firstly, do they know what is causing the low blood sugars? Is baby being kept skin to skin with mum (babies struggling to maintain their body temp can experience low blood sugar as they are working too hard to keep warm) - mum is the best baby warmer around.

The 'trouble' with BF babies is they can have low blood sugars (hypoglycaemia in technical terms) but they also burn what is known as 'alternative fuels' things like ketones and free fatty acids (lots more I can't remember) so are actually fine as they are utilising these other fuels not just glucose. If baby is then fed formula this mechanism to burn those alternative fuels is switched off so a FF baby with the same low blood sugar level can be in more danger of harm than a BF baby.

The cut off point between ok and not is very very slight (over 2.6 is fine, under 2.2 is not) and using the sticks to test blood at the bed side is not very accurate, blood should be tested in a lab machine (forget the name - sorry) not using the sticks - they are accurate with high blood sugars but not with the tiny changes that neonates may have.

Your friend should be able to speak to a Paed about their Hypoglycaemia protocol and make sure that the staff dealing with her baby are following it.

Also, jittery behaviour is NOT a sign of hypoglycaemia but rather an immature response to stimulii (babies have been observed being 'jittery' to noises, movement, sights, etc). The 'cure' for this is keeping them close to mum/dad.

Thanks for that TruthSweet, excellent information as per usual :) I will see how it goes and pass it on if there seems to be any problems. Am concious of not overloading her or raising problems where there may not be any. I have made it clear she can call on me anytime and I will do everything I can to help, even if it is just to find out info for her, sift through it and pass on what is relevent. Although I have 15m of bf under my belt I am not a bfc (though would LOVE to be) and know my limitations so will be careful to point her in the right direction to 'proper' advice if she needs it.

I'm only a trainee but the week before last went to a BFing conference and one of the speakers (DD3's paed!) did a presentation on Hypoglycaemia hence why I sound all genned up on it!

sorry trainee BFC.

Hope all goes well with her and baby. Keeping baby close and feeding frequently is the best 'treatment' for lower than liked BS (barring clinical guidance) and the Paed who did the presentation did say that she would rather a mum fed her baby than held it off so they could stick it and get an BS reading pre-feed.