Feeding a newborn with low blood sugar

[BBWBabeLisa]

Does anyone know anything about low blood sugar in newborn babies? I had my DD in January, and as I am diabetic she had to go to SCBU for about 36 hours to stabilise her blood sugars. She didn't go straight away, when she was first born the consultant checked her and said she could stay with me. Within an hour or so the midwives said her blood sugar had dropped a bit and she needed feeding. She was born 2 wks early by c-section after failed induction, and no amount of trying to stimulate my nipples would make them produce even the tiniest droplet of colostrum that soon. The midwives advised I'd be best to give her a bottle to keep her sugars up. Being rather clueless and terrified that if I didn't her blood sugars would go thru the floor and kill her I agreed. Thru the night I continued trying her to the breast every time she cried, but every time she sucked a couple of times, realised nothing was coming out and proceeded to thrash around screaming til she was given a bottle. The midwives kept assuring me that there'd be no problem bf'ing once her sugars were stable. That was utter nonsense. In the morning her blood sugars dropped lower despite the bottles and she was taken to SCBU where she remained, and continued to be bottle fed for about 36 hours, before being returned to me. No matter how many times she was put to the breast it just wasn't working, she wouldn't take it. I didn't feel I could just not give her a bottle coz I was so scared of her blood sugars. Despite expressing, and continuing to try and get her to latch for 9 weeks it never happened, and I blame the bottle entirely. Ok, so to get to the main point, we're now trying for baby number 2 and I'm desperate not to repeat this. I need to know what I can do differently. Chances are my next baby will also have low blood sugar for the first few days after birth, and I am determined to bf. Am I putting the baby at undue risk by insisting on no bottles. What options do I have? Is there any other way of stabilising her blood sugar til my milk comes in and we get bf'ing established. Please help, I know I'm not even pregnant yet but I found my inability to bf so traumatic last time I am terrified of it happening again. Would I be within my rights to ask to discuss this with one of the SCBU doctors onc I'm pregnant?

Yes, I have experience of it, although not with my firstborn.

I will find you my thread.

i had gestional diabetes with dd3. they forgot to check dd3 blood sugers straight away, so she was only checked when we were going to be discharged. we had already got breastfeeding going, and i didnt want to give bottles. i tried putting her the breast every hour, and there was a slight increase but not enough. they wanted to take her to SCBU but i refused initially, and we tried topping up with expressed. but still she didnt get a higher reading. so they took her but i said no bottles. dd3 was tube fed hourly/two hourly for 24hours in SCBU. they wanted me to carry it on back on the ward. but i started giving breastfeeds before the tube feeds. and after she bought up most of the tube feed, the midwives agreed to take the tube out. her heels were a mess, and her hands, as all of her blood tests had to be redone. her biliribin levels were reading very high, and her blood count came back very low. but she was fine.

i remember mears talkign about expresing and freezing colostrum.

mine all had this.

Ds1 - 38 week induced for high BP. Would not feed - was given a bottle of formula after a few hours. I expressed, bottle fed that - and over a month finally convinved him to breast feed - a lot of angst on both our parts - I was just more stubborn thatn him. Fed him to just over 12 months.

DS2/3 - twins - induced at 35 weeks - too small to feed. They were tube fed hourly because of low blood sugar for the first couple of days. I never got them to latch on (no time with twins and a toddler) - so expressed for 9 months, and mixed fed.

It won't necessarily happen to you again. But if it does - I would probably syrung, spoon or cup feed to begin with - not bottle feed. And just keep at it. And if it finally doesn't work - give in with good grace and know that at least you tried.

Here it is

The difference is that I knew I could breastfeed successfully because I had done so with DS1 and I could see that DS2 didn't have any ill effects. I think you need to speak to somebody who knows about breastfeeding - and don't expect this to be a midwife or a doctor, sadly, although there are some bloody great ones out there.

Misdee, yes, Mears has talked about expressing colostrum antenatally - I was going to do it and never got round to it Will if there's a next time though. That's something you could consider, BBWBL (hi, btw - recognise you from my infrequent visits to the Jan thread ).

I mean ill effects from having low clood sugar - he was fine, just like his brother had been - calm, alert, etc.

My preferred option would be expressed colostrum, syringe-fed (which I did), then IV dextrose (which they were going to do had DS2's sugars not stabilised). Had I had to give him formula later on (if I'd not managed to express enough or get access to donor milk), I'd have insisted he was cup or syringe fed that too.

Also, if you need to give formula to regulate blood sugar why did they do this with a bottle and not with a cup?

DS had low blood sugar when he was born by planned section. I was at Queen Charlotte. They did ask if they could give formula but they showed up with a cup not a bottle.

There's nothing intrinsically better about a cup rather than a bottle - truly. I know it's said the sucking action on the breast is not 'confused' with a cup, but there is no evidence for this.

The risk with a bottle is that the baby slurps in more than he needs, and then learns to 'expect' huge amounts....the amount of milk a baby needs to stave off low blood sugar can be given without giving too much if a cup is offered, but again, there's no real evidence to make this certain.

It is a recognised issue with diabetic mothers, and for this reason, some places encourage antenatal expression of colostrum so the baby can have it while he's waiting.

Lisa, you could investigate this, or perhaps the use of donated human milk, fed by tube if you were ok about this.

Hope it works out.

Thanks everyone, lots of stuff to think about there. I'll definitely be getting help from a breastfeeding expert if/when the time comes, and I'll look into expressing colostrum. It was never mentioned to me at my hospital but maybe they just need a push!

Hunker I just read your thread! If I'm fortunate enough to get pregnant again this time will you please come and stand up to the nasty doctors/midwives when I have the baby!!!! You're my hero, thats exactly how I WISH I had been with them.

tiktok - I know that is the perceived wisdom - but from personal experience my DS1 just would not latch on - screamed as if we were torturing him (it was awful). It took a month - but finally I got him feeding - but initially I had to fool him by expressing a bit, putting it in an avent teat, putting that ove my nipple, get him sucking on that - and then once he was feeding whip off the teat, stick in my nipple and hope he didn't notice !

It was almost as if he had got it into his head he needed to be sucking on a plastic teat (even nipple shields we not good enough for him !).

Sorry, throckenholt, not sure which bit of my post you're commenting on.

Your experience (kudos to you for persisting!) is something I have come across occasionally - using the teat to get the baby sucking somehow. It's also how nipple shields are occasionally used. The teat/shield gets into the mouth more 'firmly' and the baby sucks in a reflex response.

Something has usually happened somehow to make the baby reluctant to suck on the breast, maybe in the first day or so. Or the baby has a sore head from the birth (long obstructed labour, forceps).

Tiktok this bit

There's nothing intrinsically better about a cup rather than a bottle - truly. I know it's said the sucking action on the breast is not 'confused' with a cup, but there is no evidence for this.

Actually I started by syringe feeding DS1 (he was induced at 38 weeks, syntocinon drip, vaginal delivery, no forceps etc, epidural).

I think because I was still tied up to the drip for the first few hours we didn't get much chance to breast feed. Anyway - by the time we got home 2 days later he was bottle fed because syringe feeding was taking ages. I had never heard of cup feeding at that stage !

I don't know why DS decided he had to be fed via the bottle teat - but he was pretty adamant ! As I said - even nipple shields were rejected. Luckily I was more stubborn than him and finally convinced him to do it properly .

He was a bit jaundiced and sleepy for the first few days - maybe that contributed.

So all I was saying is that sometimes bottle feeding can cause confusion - but I think maybe our situation was a bit odd. I just think maybe if we had cup fed he would have had no experience of sucking on anything else when we tried to breast feed.