Low Glucose at birth - breastfeeding vs formula question

SkiChic626 · April 2016

I'm not sure if any other experienced moms can chime in on this....So at birth, DD was over the 9lb5oz limit (she was 9lbs13oz) so they tested her blood glucose and it was low (well no sh*t, you haven't let me eat anything for the past 2 days, of course her blood sugar is low, mine probably is, too!). Anyway, since it was low, while they did let her lay on my chest for a few minutes while they were stitching me up (c-section), they very soon after whisked her away, I sent DH to make sure not to take his eyes off her, and they immediately fed her formula to get her blood sugar up. There was absolutely nothing I could do about this, I was still open with my guts exposed in an OR and I didn't even know this was happening at the time until DH told me afterwards. Now, don't get me wrong, I don't think it affected my breastfeeding success, I was fairly successful, we made it to 7.5 months when I got my period back and my milk disappeared, and then another 2 months with my freezer stash. I know people make it a lot longer, but no one in my real life has ever made it past about 3 months, so I consider myself pretty successful. Anyway....my question is, was that completely necessary for them to give her formula? Couldn't they have given her to me once I was in recovery and had me nurse her? I feel like I didn't have a choice in that decision, and quite frankly I think she would have been just fine while she waited for mama to nurse her. Her glucose was low because I was induced and they wouldn't let me eat anything - DUH!! Anyone know??? If the same thing happens this time, which it very well may because I'm expecting a boy to be even bigger than his sister, I want to know first what's going on and second whether I can say no and try to handle it myself.

mmclark10 · April 2016

Can you ask your pediatrician in advance what the reasoning would have been and whether or not that could be avoided?

PineappleMD · April 2016

Babies don't have low glucose because their mothers do - big babies have low glucose because of the relationship between glucose utilization and fat stores. Which is why the size of the baby makes them check for low glucose in the first place - not how long mom has been in labor or how long mom hasn't been allowed to eat.

That being said, "low glucose" is obviously a range... from the "holy shit this baby is about to have a seizure and go into a coma" low, to "eh, let's let them BF for a bit and see how they do".

Questions to ask if this happens again:
1. What is the actual number of the glucose level? The goal is 45 or higher (within the first 4 hours of life - this number changes later on). Anything less than 20 or 25 can be super dangerous for the baby -- we're talking the potential for seizures and coma. So if it's that low, just let the staff do their thing.
2. Ask for the policy on when they use formula. Some hospitals do it for any baby below 45, some have different cutoffs. It's good to know what to expect from your institution.
2. Ask them to recheck again after you BF. Even if it's a short feed, it might be enough to get the glucose above that scary threshold level.

But in the end, "health baby healthy mom" is the goal of every delivery ward, so if that means one bottle to get baby through a tough time, then be glad that's all it took! And you ended up doing a kick-ass job breast-feeding anyway, so kudos to you!!

ginger819 · April 2016

I agree with pp on asking what the policy is, but in my experience it took a while for DD to completely figure out BFing (and me getting to know the correct latch) plus my milk didn't come in until the next morning really. Personally if DD had had low blood sugar I know I probably would not have been able to get enough into her to counteract that right away.

Stephanie7693 · April 2016

My daughter was small at birth, 5lb 6oz. They gave her sugar water through a nuk with a syringe in special care to get her blood sugar up until I could nurse. But I have no idea how low it was. She ended up being given formula the next day anyway bc my milk didn't come in for 5 days and they wouldn't let her lose any more weight than she had already. So I would ask if sugar water is an option, and that it not be in a bottle.

JLyn821 · April 2016

My son was 9lbs 10oz at birth. He was born on a Friday evening and I was able to start nursing within his first hour. They continued to monitor his glucose levels and, as his levels were still low come Saturday night, the nurses suggested a bit of formula. He wouldn't take it from me. I was ok with them giving it a try and he did take it from them in the nursery (away from me and my scent). His blood sugar levels definitely raised and he was good to go.

So even though I'd been nursing him for over 24 hours, my colostrum wasn't doing the trick. It also didn't have any effect on my supply or his feeding ability. I weaned him at a year.

I find it odd that they took your daughter so quickly after birth without giving you a real chance to nurse her. My hospital gave me 24 hours before giving me the formula option.

This time, I'd suggest telling hospital staff that you prefer to nurse before they "insist" on formula. That you want to actually have the chance to feed your child before they do their thing.

ThisisNumber3 · April 2016

PineappleMD said:

Babies don't have low glucose because their mothers do - big babies have low glucose because of the relationship between glucose utilization and fat stores. Which is why the size of the baby makes them check for low glucose in the first place - not how long mom has been in labor or how long mom hasn't been allowed to eat.

That being said, "low glucose" is obviously a range... from the "holy shit this baby is about to have a seizure and go into a coma" low, to "eh, let's let them BF for a bit and see how they do".

Questions to ask if this happens again:
1. What is the actual number of the glucose level? The goal is 45 or higher (within the first 4 hours of life - this number changes later on). Anything less than 20 or 25 can be super dangerous for the baby -- we're talking the potential for seizures and coma. So if it's that low, just let the staff do their thing.
2. Ask for the policy on when they use formula. Some hospitals do it for any baby below 45, some have different cutoffs. It's good to know what to expect from your institution.
2. Ask them to recheck again after you BF. Even if it's a short feed, it might be enough to get the glucose above that scary threshold level.

But in the end, "health baby healthy mom" is the goal of every delivery ward, so if that means one bottle to get baby through a tough time, then be glad that's all it took! And you ended up doing a kick-ass job breast-feeding anyway, so kudos to you!!

Great post! I had LGA babies but their glucose was ok and they let me go a while with a good weight drop without formula. Their jaundice levels were also zero.

Curls919 · April 2016

Just adding in my experience, DS wouldn't latch so they came in on our second night in the hospital and said "his blood sugar is too low, we're giving him formula". He was also 6lb 6oz. For us there was no alternative. He needed to eat (he was also slightly jaundice) and he obviously wasn't getting enough from me. We went on to nurse for 15 months.

i agree with pp that in your situation I would have wanted to try nursing first, though if they gave formula immediately it sounds like maybe the baby's blood sugar was dangerously low. In which case id just want them to do whatever is needed to get my baby healthy.

SkiChic626 · April 2016

JLyn821 said:

My son was 9lbs 10oz at birth. He was born on a Friday evening and I was able to start nursing within his first hour. They continued to monitor his glucose levels and, as his levels were still low come Saturday night, the nurses suggested a bit of formula. He wouldn't take it from me. I was ok with them giving it a try and he did take it from them in the nursery (away from me and my scent). His blood sugar levels definitely raised and he was good to go.

So even though I'd been nursing him for over 24 hours, my colostrum wasn't doing the trick. It also didn't have any effect on my supply or his feeding ability. I weaned him at a year.

I find it odd that they took your daughter so quickly after birth without giving you a real chance to nurse her. My hospital gave me 24 hours before giving me the formula option.

This time, I'd suggest telling hospital staff that you prefer to nurse before they "insist" on formula. That you want to actually have the chance to feed your child before they do their thing.

Thinking back, I'm surprised, too, because they are a top 50 hospital and even added to that baby friendly list, or whatever it's called, because they advocate breastfeeding, AND I had my midwife there who knew I wanted to BF. I'm assuming it wasn't urgent because they let me hold her a while before they said they needed to take her. Who knows....I was so out of it at that point just trying to focus on breathing while they closed me up I barely remember how it all unfolded.

SkiChic626 · April 2016

@PineappleMD I assumed it was correlated because all the drs and nurses kept asking me if I had GD because of her weight and the glucose thing. I didn't, and I was tested twice because I have PCOS and both times I passed the one hour with flying colors. Anyway, that's why I assumed it was related, no one told me otherwise at the time.

I totally agree with healthy baby healthy mom , of course, but part of the reason i wasn't happy was because DH said she took the entire 2oz bottle they offered her. Aren't their tummies the size of a marble at birth?? That just seems like an astronomical amt for her just a few minutes after birth.

I'm definitely going to ask the questions you posed this time, so thanks for that!!

ThisisNumber3 · April 2016

@SkiChic626 - Is there a way for you to request a copy of her birth records? Maybe it would give you some answers. Maybe your OB could help you navigate?

SkiChic626 · April 2016

@ThisisNumber3 I suppose I could. I never really gave it much thought until recently - something made a light bulb go off and be like wait, what?? At this point it's water under the bridge, I just wish I had more information when it was happening so that I could have asked more questions. I mean, I'm the type of person who refused to sign paperwork for my egg retrieval surgery before I got to talk one-on-one with the anesthesiologist lol, so yeah, I need my info dammit!

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