A dilemma we face in obstetrical care is how to best support mothers and newborns to remain together and exclusively breastfeed when the newborn experiences transitional neonatal hypoglycemia.
We know that at birth the infant’s blood glucose level is about 70% of the maternal level and falls during the first two hours of life. For otherwise healthy newborns, this is labeled transitional hypoglycemia and is normal.
There is strong evidence that skin to skin contact between mothers and infants has numerous benefits, including glycemic regulation. Breastmilk also confers many health benefits and positively affects blood glucose levels. The AAP has long supported exclusive breastfeeding for the first six months of life followed by breastfeeding in combination with the introduction of food until at least the first year of life.
The standard treatment for transitional hypoglycemia has been to introduce formula and IV dextrose with a NICU admission, interrupting exclusive breastfeeding and leading to mother/newborn separation. A practice that has taken rise over the last 5 years is the introduction of 0.5mg/kg of 40% glucose gel administered to the buccal mucosa supporting exclusive breastfeeding and mother newborn non separation.
Catherine Bennett, APN/CNS